DRUGS AND THEIR MECHANISM OF ACTION

DRUGS AND THEIR MECHANISM

Drug Mechanism of action Digitalis glycosides inhibits Na-k-ATPase enzyme Omeperazole inhibits H-k-ATPase mupirocin Inhibits iso leucyl tRNA synthetase Disulphuram inhibits aldehyde dehydrogenase Coumarins inhibits vitamin K epoxide reductase Allopurinol inhibits xanthine oxidase enzyme Aspirin COX1 inhibitor, causes ulcer due to PG inhibition Benorylate COX1 inhibitors (causes ulcer) Indomethacin COX1 inhibitors (causes ulcer) Diclofenac COX1 inhibitors (causes ulcer) Phenyl butazone COX1 inhibitors (causes ulcer) Oxyphenyl butazone COX1 inhibitors (causes ulcer) Naproxan COX1 inhibitors (causes ulcer) Ibuprufen COX1 inhibitors (causes ulcer) Ketoprufen COX1 inhibitors (causes ulcer) Piroxicam COX1 inhibitors (causes ulcer) Azapropazone COX1 inhibitors (causes ulcer) Nabumetone COX1 inhibitors (causes ulcer) Rafecoxib selective COX2 inhibitor, no ulcer Celecoxib selective COX2 inhibitor, no ulcer Nimeuselide selective COX2 inhibitor, no ulcer Glucocorticoids selective COX2 inhibitor, no ulcer Picrotoxin GABA antagonist Amitryptline GABA agonist, hyperpolarisation (Cl ↑) Diazepam GABA agonist, hyperpolarisation (Cl ↑) Imipramine GABA agonist, hyperpolarisation (Cl ↑) Probenicid expells out uric acid in arthritis Sulfinpyrazole expells out uric acid in arthritis Pyridostigmine anti-cholinestrase (ACH ↑) Neostigmine anti-cholinestrase (ACH ↑) Pilocarpine cholinergic alkaloid Trihexiphenidyl anti-cholinergic Biperidin anti- cholinergic Benztropine anti- cholinergic Procyclidine anti- cholinergic Hemicholinum inhibits reutake of ACH Vasamicol inhibits transport of ACH Botulinum toxin inhibits release of ACH Ritodrine β2 agonist Midodrine α1 agonist Metaraminol β1 agonist Adrenaline α and β agonist Noradrenaline α1, α2, β1agonist Dopamine α1, β1, D1, D2 agonist Dobutamine β1 agonist Orciprenaline β2 agonist Isoprenaline β2 agonist Salmetrol β2 agonist Isoxoprine β2 agonist Salbutamol β2 agonist Terbutaline β2 agonist Phenylepherine α agonist Oxymetazoline α agonist Xylometazoline α agonist Phenylpropanolamine α agonist Amphetamine replaces and releases adrenaline Tyramine replaces and releases adrenaline Mazindol dopamine releaser in CNS Ephederine adrenaline releaser Fenfluramine increases 5-HT transport in CNS Flumazenil benzodiazepene antidote(replacer) Flunrazine calcium channel blocker Ketamine inhibits dopamine reuptake Clonidine α2 agonist Methyl dopa α2 agonist Guanabenz α2 agonist Protamine sulphate Heparin antagonist from fish Phentolamine α blocker (equilibrium, non selective) Tolazoline α blocker (equilibrium, non selective) Phenoxybenzamine α blocker (non equilibrium, non selective) Prazocin α1 blocker Terazocin α1 blocker Trimazocin α1 blocker Indoramine α1 blocker Yohimbine α2 blocker from reserpine Sildenafil (viagra) inhibits phosphodiesrerase 5, increases cAMP↑ Ergot alkaloids α and 5-HT partial agonist, β blockers Ketanserine 5-HT antagonist Chlorpromazine dopamine antagonist Atenolol β1 blocker Acebutolol β1 blocker Butaxolol β1 blocker Metoprolol β1 blocker Sotalol β1, β2 blocker Timolol β1, β2 blocker Pindolol β1, β2 blocker Prpanolol β1, β2 blocker Labetolol β1, β2, α blocker Methyl tyrosine inhibits tyrosine hydroxylase Imipramine inhibits NA uptake Cocaine inhibits NA uptake Bretylium inhibits NA release Guanethidine inhibits NA release Nicotine(small dose) ganglionic stimulant (NA↑) Nicotine(high dose) ganglionic blocker (NA↓) Mecamylamine ganglionic blocker (NA↓) Hexamethonium ganglionic blocker (NA↓) Trimethophan ganglionic blocker (NA↓) Pentolinium ganglionic blocker (NA↓) Succinylcholine NM blocker by depolarisation (sodium out) Tubocurorine(longer) NM blocker, prevent ACH binding to NM receptor Gallamine(longer) NM blocker, prevent ACH binding to NM receptor Pancuronium(longer) NM blocker, prevent ACH binding to NM receptor Mivacurium(intermediate) NM blocker, prevent ACH binding to NM receptor Atracurium(short) NM blocker, prevent ACH binding to NM receptor Vecuronium(short) NM blocker, prevent ACH binding to NM receptor Dantroline Ca↓from muscles directly Quinine(-) Ca↓from muscles directly Diazepam Cl↑or hyperpolarisation, GABA agonist Baclofen Cl↑or hyperpolarisation, GABA agonist Benzocaine Na↓out Cocaine Na↓out Procaine Na↓out Lidocaine Na↓out Bupivacaine Na↓out Prilocaine Na↓out Prostaglandins anti ulcer, anti platelet, vasodilation Enoxaperin sodium An anti coagulant, activates antithrombin 3 Thromboxanes Causes platelet aggregation Leucoterines (LT4) causes bronchoconstriction (asthma) Bradykinin vasodilation, cough Histamine vasodilation, bronchoconstriction (anaphylaxis) Adrenaline vasoconstriction, bronchodilation Interferon-α anti-cancer Interferon-β in fibroblasts Interferon-γ in wbc Interlukins (anti-cancer) stimulate T-lymphocytes and kill m/o Encephalins morphine δ agonist Pheniramine H1 blocker (anti-histamines) Meclizine H1 blocker (anti-histamines) Buclizine H1 blocker (anti-histamines) Cinnarizine H1 blocker (anti-histamines) Cyprohepatadine H1 blocker (anti-histamines) Clemastine H1 blocker (anti-histamines) Promethazine H1 blocker (anti-histamines) Diphenhydramine H1 blocker (anti-histamines) Astemizole H1 blocker (anti-histamines) Hydroxizine H1 blocker (anti-histamines) Azatidine H1 blocker (anti-histamines) Loratidine H1 blocker (anti-histamines) Turfinadine H1 blocker (anti-histamines) Dimenhydrinate H1 blocker (anti-histamines) Cimitidine H2 blocker ( anti ulcer) Ranitidine H2 blocker ( anti ulcer) Famotidine H2 blocker ( anti ulcer) Promethazine & vit B6 morning sickness (vomit) treatment in pregnancy Acetazolamide mountain sickness (vomit) treatment Hyoscine motion sickness(vomit) treatment, anti cholinergic Buspirone 5-HT agonist Sumatriptan 5-HT agonist Cisapride 5-HT agonist, prokinetic agent Clozapine 5-HT antagonist Resperidole 5-HT antagonist Methylsergide 5-HT antagonist Pizotifen 5-HT antagonist Ondensteron 5-HT antagonist Ketanserine 5-HT antagonist Carboprost(PG-F2α) induces uterine contrctions Dinoprostone(PG-E) induces uterine contrctions (abortion) Mesoprost(PG-E1) anti ulcer Prostacyclin(PG-I2) prevent platelet aggregation Epoprostinol(PG-I2) prevent platelet aggregation Metoclopramide D2 blocker, increases prolactin release Domperidone D2 blocker, increases prolactin release Captopril ACE inhibitors Enalaprilat(prodrug) ACE inhibitors Lisinopril ACE inhibitors Ramiprilat(prodrug) ACE inhibitors Perindopril(prodrug) ACE inhibitors Losartan angiotensin antagonist Telmisartan angiotensin antagonist Valsartan angiotensin antagonist Nifidipine calcium channel blocker Felodipine calcium channel blocker Amlodipine calcium channel blocker Verapamil calcium channel blocker Diltiazem calcium channel blocker Flunrazine calcium channel blocker Nitric oxide Activates Guanyl cyclase, increases cGMP↑ Furosemide inhibits Na,k,Cl absorption Ethacranic acid inhibits Na,k,Cl absorption Bumetinide inhibits Na,k,Cl absorption Thiazides inhibits Na,k absorption, decreases insulin level Chlorthiazide inhibits Na,k absorption, decreases insulin level Hydrochlorthiazide inhibits Na,k absorption, decreases insulin level Indapamide inhibits Na,k absorption Acetazolamide carbonic anhydrase inhibitor Mannitol fascilitate osmosis Sorbitol fascilitate osmosis Caffine inhibits Na and k absorption Theophylline inhibits Na and k absorption Theobromine inhibits Na and k absorption Amiloride inhibits Na absorption Triameterine inhibits Na absorption Spiranolactone aldosterone receptor antagonist Hydralazine k channel opener & NO releaser Nitroglycerine NO releaser Diazoxide k channel opener, decreases insulin level Minoxidil k channel opener, hypertrichosis (hairs on hand) Nicorandil k channel opener(veins and arteries) Nitropusside NO releaser Heparin & enoxaperin activates anti-thrombin 3 Warfarin inhibits vitamin K epoxide reductase Phenindione inhibits vitamin K epoxide reductase Amrinone inhibits phosphodiesrerase, increases cAMP↑ Sildenafil(viagra) inhibits phosphodiesrerase, increases cAMP↑ Dipyridamole inhibits phosphodiesrerase, increases cAMP↑ Alpha-blockers inhibits phosphodiesrerase, increases cAMP↑ Caffine inhibits phosphodiesrerase, increases cAMP↑ Digitalis inhibits Na-k-ATPase enzyme (Na↑, k↓) Digoxin inhibits Na-k-ATPase enzyme (Na↑, k↓) Digitoxin inhibits Na-k-ATPase enzyme (Na↑, k↓) Trimetazidine removes lactic,pyruvic acid frm heart& relive pain Resins inhibits bile reabsorption Cholestramine inhibits bile reabsorption Cholestipol inhibits bile reabsorption Atorvastatin inhibits HMGCoA reductase Lovastatin inhibits HMGCoA reductase Simvastatin inhibits HMGCoA reductase Fibrates activtes lipase & results ω oxidation of triglyceride Nicotinic acid inhibits FFA release Niacin inhibits FFA release Acipimox inhibits FFA release Probucol anti-oxidant Amidorone calcium channel blocker Bretylium inhibits NA release Beta blokers block beta receptors Calcium chenel blockers block calcium channels Propafenone fastens repolarisation or k ions out Maxiletine depolarisation↑, repolarisation↓ Lidocaine depolarisation↑, repolarisation↓ Phenytoin depolarisation↑, repolarisation↓ Dysopramide depolarisation↓, repolarisation↑ Procainamide depolarisation↓, repolarisation↑ Quinidine(+) depolarisation↓, repolarisation↑ Emetine induce vomiting Cephaline induce vomiting Apomorphine induce vomiting Ipecac induce vomiting Salt solution induce vomiting Morphine µ agonist Codiene µ agonist Thebaine µ agonist Pentazocin mixed agonist(k) & antagonist(µ) Buprenorphine mixed agonist(k) & antagonist(µ) Naloxone morphine antagonist Nalorphine morphine antagonist Streptokinase plasminogen activating factor Urokinase plasminogen activating factor Alteplase(rt-PA) plasminogen activating factor T-PA(natural) plasminogen activating factor Kallikarein plasminogen activating factor Antistreplase plasminogen activating factor Aspirin inhibits platelet aggregation (thromboxanes) Sulfinpyrazole inhibits platelet aggregation( thromboxanes) Dipyridamole inhibits phosphodiesterase, cAMP↑ Ticlopidine blocks ADP receptor Clopidogril blocks ADP receptor Epoprostinol(PG-I2) inhibits platelet aggregation Pentoxyphyline reduces blood viscosity Xanthines bronchodilation by inc cAMP↑ Caffiene bronchodilation by inc cAMP↑ Theophyline bronchodilation by inc cAMP↑ Theobromine bronchodilation by inc cAMP↑ Disodium chromoglycate inhibits mast cell degranulation Nedocromil inhibits mast cell degranulation Ketotifen inhibits mast cell degranulation Acetylcysteine breaks mucus (mucolytic) Carbocysteine breaks mucus (mucolytic) Bromhexine breaks mucus (mucolytic) Pot.iodide increases water & viscosity↓ of mucus Amonium chloride increases water & viscosity↓ of mucus Ipecac increases water & viscosity↓ of mucus Guiphensein increases water & viscosity↓ of mucus Codiene centraly acting antitussives Pholcodeine centraly acting antitussives Dextromethorphan centraly acting antitussives Noscapine centraly acting antitussives Proglumide anti gastrin (a hormone causing ulcer) Progabide GABA agonist Pergolide D1, D2 agonist Aluminium hydroxide antacid Mag. Hydroxide antacid Mag. Trisilicate antacid Sod. Bicarbonate antacid Bismuth subsalicylate protect mucosa, pepsin↓, mucus↑, bicarbonate↑ Sucralfate protect mucosa, pepsin↓, mucus↑, bicarbonate↑ Carbenoxlone sodium protect mucosa, pepsin↓, mucus↑, bicarbonate↑ Mesoprost(PG-E1) inhibits acid production in stomach Metoclopramide D2 blocker, prokinetic agent, increases prolactin Domperidone D2 blocker, prokinetic agent, increases prolactin Cisapride 5HT-agonist, prokinetic agent Vefopitant neurokinin-1 antagonist Methyl cellulose bulk luxative Agar bulk luxative Sterculia gum bulk luxative Isapgulha bulk luxative Bran bulk luxative Lactulose osmotic luxative Mannitol osmotic luxative Sorbitol osmotic luxative Mag. Silicate osmotic luxative Mag. Hydroxide osmotic luxative Docusate sodium faecal softner (detergent) Bisacodyl stimulant pugative (muscle movements↑) Sod. Picosulphate stimulant pugative (muscle movements↑) Loperamide reduces faecal outlet frequency Mebeverine smooth muscle relaxant Reserpine blocks NA binding (B.P↓) Tegaserod partial 5HT-agonist Tetracycline inhibits protein synthesis (30 s, A site) Amino glycosides inhibits protein synthesis (30 s, A site) Streptomycin inhibits protein synthesis (30 s, A site) Gentamycin inhibits protein synthesis (30 s, A site) Tobramycin inhibits protein synthesis (30 s, A site) Amikacin inhibits protein synthesis (30 s, A site) Netimycin inhibits protein synthesis (30 s, A site) Chloramphenicol inhibits protein synthesis (50 s, P site) Macrolides inhibits protein synthesis (50 s, P site) Clarithromycin inhibits protein synthesis (50 s, P site) Azithromycin inhibits protein synthesis (50 s, P site) Erythromycin inhibits protein synthesis (50 s, P site) Neomycin inhibits protein synthesis (50 s, P site) Clindamycin inhibits protein synthesis (50 s, P site) Penicillin inhibits transpeptidase, no cell wall formation Cephalosporin inhibits transpeptidase, no cell wall formation Gresiophulvin inhibit mitosis Ketokonazole inhibits 14-α-demethylase enzyme Itroconazole inhibits 14-α-demethylase enzyme Miconazole inhibits 14-α-demethylase enzyme Oxiconazole inhibits 14-α-demethylase enzyme Amphotericin inhibit 14-α demethylase (pore formation) Hamycin inhibit 14-α demethylase (pore formation) Natimycin inhibit 14-α demethylase (pore formation) Nysstatin same as above,pore in cell wall Polymixin cell wall leakage as above Actinomycin inhibit DNA dependent RNA polymerase Rifampicin inhibit DNA dependent RNA polymerase Rifabutin inhibit DNA dependent RNA polymerase Floro quinones inhibits DNA gyrase Novobiocin inhibits DNA gyrase Pentostatin inhibits adenosine deaminase Substance p emetic, act at neurokinin-1 receptor ciprofloxacin Inhibits DNA gyrase enzyme Sulfisoxazole inhibits folate synthtase Sulfadiazine inhibits folate synthtase Sulfamethoxzole inhibits folate synthtase Trimethoprim inhibits dihydrofolate reductase Sulfamethoxapyridazine inhibits folate synthtase Pyrimethamine inhibits dihydrofolate reductase Proguanil inhibits dihydrofolate reductase Sulfasalazine inhibits folate synthtase Sulfaguanidine inhibits folate synthtase Sulfacetamide inhibits folate synthtase Mefenide inhibits folate synthtase Silver sulfasalzine inhibits folate synthtase Ofloxacin inhibits DNA gyrase Levofloxacin inhibits DNA gyrase Ciprofloxacin inhibits DNA gyrase Topotecan inhibits topoisomerase 1 Mitoxanthrone inhibits topoisomerase 2 Podophylum inhibits topoisomerase 2 Penicillin G natural penicillin Penicillin V acid resistant penicillin Methicilin penicilinase resistant penicillin Cloxacillin penicilinase resistant penicillin Nafecillin penicilinase resistant penicillin Oxacillin penicilinase resistant penicillin Salbactum beta-lactamase (suicide) inhibitor Tazobactum beta-lactamase (suicide) inhibitor Clvulinic acid beta-lactamase (suicide) inhibitor Mupirocin inhibits isoleucyl tRNA synthetase Fosfomycin inhibits endopyruvte transferase Streptogramin inhibits protein synthesis (50 s,P site) Nitrofurantoin inhibits DNA & RNA synthesis Methenamine releases HCHO (bactericidal) Phenazopyridine analgesic and relieve burns Isoniazid inhibits mycolic acid synthesis Ethionamide inhibits mycolic acid synthesis Thiacetazone inhibits mycolic acid synthesis Pyrazinamide inhibits mycolic acid synthesis Ethambutol inhibits mycolic acid synthesis Dapsone inhibits folate synthtase Clofazamine anti-inflammatory Flucytosine anti metabolite (inhibit protein synthesis) Terbinafine inhibits squaline epoxidase enzyme Pneumocandin inhibits cell wall synthesis Acyclovir inhibits viral DNA polymerase Pencyclovir inhibits viral DNA polymerase Vancyclovir inhibits viral DNA polymerase Idoxuridine inhibits viral DNA polymerase Trifluridine inhibits viral DNA polymerase Vidaberine inhibits viral DNA polymerase Cidofovir inhibits viral DNA polymerase Valacyclovir inhibits viral DNA polymerase Amantadine uncoating of viral assembly Rimintadine uncoating of viral assembly Zanamivir inhibits budding & release of new virus Osllamivir inhibits budding & release of new virus Ribavarin inhibits viral DNA & RNA polymerase Interferones inhibits transcription & translation Interferones inhibits viral assembly formation Zidovudine inhibit nucleoside reverse transcriptase Stavudine inhibit nucleoside reverse transcriptase Lamivudine inhibit nucleoside reverse transcriptase Didanosine inhibit nucleoside reverse transcriptase Abecavir inhibit nucleoside reverse transcriptase Zalcitabine inhibit nucleoside reverse transcriptase Nevirapine inhibit non nucleoside reverse transcriptase Efaveranz inhibit non nucleoside reverse transcriptase Dalaverdine inhibit non nucleoside reverse transcriptase Ritonavir inhibits protease enzyme Indinavir inhibits protease enzyme Amprenavir inhibits protease enzyme Saquinavir inhibits protease enzyme Tenofovir inhibit nucleotide reverse transcriptase Zintevir inhibits integrase enzyme Quinine inhibits heam polymerase Chloroqunine inhibits heam polymerase Mefloquinine inhibits heam polymerase Halofantrine inhibits heam polymerase Atovaquone inhibits elctron transport chain or ETC Artemisinin releases free radicals Metronidazole cell death in presence of nitrate reductase enz Albendazole inhibit microtubule formation, glucose supply Thiabendazole inhibit microtubule formation, glucose supply Mebendazole inhibit microtubule formation, glucose supply Pyrental increases ACH, NM blocker Praziquental increases Calcium inflex thus paralysis Ivermectin GABA agonist Progabide GABA agonist Tiagabine inhibits GABA reuptake Viagabatrine GABA agonist Lamotrigine inhibits amino acids formation Levodopa dopamine precursor Carbidopa inhibits levodopa decarboxylation Amantadine dopamine releaser in cns Bromcryptine D1 agonist Lysuride D1 & D2 agonist Pergolide D1 & D2 agonist Pramipexole D2 agonist Selegnine MAOB inhibitor Pergyline MAOB inhibitor Deprenyl MAOB inhibitor Phenelzine MAOA inhibitor Tranylcypromine MAOA inhibitor Isocarboxacid MAOA inhibitor Tolcapone COMT inhibitor Barbital(long) hyperpolarisation (Cl ↑,k ↓) Phenobarbital(long) hyperpolarisation (Cl ↑,k ↓) Mephobarbital(long) hyperpolarisation (Cl ↑,k ↓) Amobarbital(inter) hyperpolarisation (Cl ↑,k ↓) Probarbital(inter) hyperpolarisation (Cl ↑,k ↓) Butabarbital(inter) hyperpolarisation (Cl ↑,k ↓) Cyclobarbital(short) hyperpolarisation (Cl ↑,k ↓) Heptabarbital(short) hyperpolarisation (Cl ↑,k ↓) Pentobarbital(short) hyperpolarisation (Cl ↑,k ↓) Secobarbita(short) hyperpolarisation (Cl ↑,k ↓) Hexobarbital( ultra short) hyperpolarisation (Cl ↑,k ↓) Thiopentone(ultra short) hyperpolarisation (Cl ↑,k ↓) Promazine blocks dopamine receptors Chlorpromazine blocks dopamine receptors Triflupromazine blocks dopamine receptors Halolperidol, blocks dopamine receptors droperidol blocks dopamine receptors Thixines blocks dopamine receptors Clozapine 5HT-antagonist Resperidol 5HT-antagonist Pimozide blocks dopamine receptors Thioridazine blocks dopamine receptors Pethidine blocks dopamine receptors Imipramine NA & serotonin reuptake inhibitor Amitryptline NA & serotonin reuptake inhibitor Diazepam Hyperpolarisation (Cl ↑,k ↓) Prazapam hyperpolarisation (Cl ↑,k ↓) Nitrazepam hyperpolarisation (Cl ↑,k ↓) Oxazepam hyperpolarisation (Cl ↑,k ↓) Lorazepam hyperpolarisation (Cl ↑,k ↓) Floxetine serotonin reuptake inhibitors Proxitine serotonin reuptake inhibitors Flovoxamine serotonin reuptake inhibitors Trazadone serotonin reuptake inhibitors Ketamine dopamine reuptake inhibitor Imipramine NA, dopamine reuptake inhibitor Hemicholinum ACH reuptake inhibitor Meprobamate hyperpolarisation (Cl ↑,k ↓) Phenytoin Na channel blocker Hydantoin Na channel blocker Valproic acid inhibits GABA transaminase (no metabolism) Ethosuccimide Ca channel blocker Cabamazepine Na channel blocker Diazepam chloride channel opener (Cl ↑) Methiamazole inhibits thyroid hormone synthesis Carbimazole inhibits thyroid hormone synthesis Centimazole inhibits thyroid hormone synthesis Thiocynates inhibits iodide trapping Perchlorates inhibits iodide trapping Sulphates inhibits iodide trapping Iodide inhibit thyroid hormone release Sod. Iodide inhibit thyroid hormone release Pot. Iodide inhibit thyroid hormone release Lugol iodine solution inhibit thyroid hormone release Radioactive iodine destroys thyroid gland tissue Tolbutamide increases insulin release Chlorpropamide increases insulin release Acetoxamide increases insulin release Tolazamide increases insulin release Glibenclamide insulin release↑, resistance↓ Glimipride insulin release↑, resistance↓ Biguanides hepatic glucose production↓, send in muscle↑ Phenformin hepatic glucose production↓, send in muscle↑ Metformin hepatic glucose production↓, send in muscle↑ Pioglitazone insulin sensitivity ↑ Acarbose inhibits α-glucosidase enzyme Maglitol inhibits α-glucosidase enzyme Estradiole estrogen (natural) Mestranol estrogen (synthetic) Clomiphene anti estrogen Tamoxiphen anti estrogen Lynesterol progesterone Levenogestril progesterone Norethisterone progesterone Allylestrenol progesterone Mifepristone anti progesterone Testosterone androgen Mesterolone anbolic steroid Ethylestranol anbolic steroid Nandrolone anbolic steroid Stanazolone anbolic steroid Oxymetalone anbolic steroid Danazole anti androgen Flutamide anti androgen Cylcophosphamide alkylating agent Efosphamide alkylating agent Clorambucil alkylating agent Lomustine alkylating agent Busulphen alkylating agent Mesna alkylating agent Thio-tepa alkylating agent Mechlorethamine alkylating agent Methotrexate structure like folic acid (antimetabolite) 5-floro uracil antimetabolite 6-mercaptopurine antimetabolite Cytarabine inhibits DNA polymerase Fludarabine inhibits RNA polymerase Dactinomycin inhibits DNA dependent RNA polymerase Actinomycin inhibits DNA dependent RNA polymerase Daunorubicin intercelates DNA Doxorubicin intercelates DNA Bleomicin intercelates DNA Mitomycin inhibits protein formation Vincristine ↓amino acid metabolism,metaphase arrest Vinblastine ↓amino acid metabolism,metaphase arrest Paclitexal tubules formation without MAP & GTP Decatexal tubules formation without MAP & GTP Irinotecan inhibits topoisomerase 1 Topotecan inhibits topoisomerase 1 Etoposide inhibits topoisomerase 2 Mitoxanthrone inhibits topoisomerase 2 Cisplatin cross links DNA Carboplatin cross links DNA L-asperginase inhibits essential amino acid asparaginine Hydroxyurea metaphase arrest at G1-S phase Prednisolone glucocorticoids Prednisone glucocorticoids Dexamethasone glucocorticoids Paramethasone glucocorticoids Cortisone glucocorticoids Hydrocortisone glucocorticoids Fludrocortisone mineralocorticoids Deoxycorticosterone mineralocorticoids Aldosterone mineralocorticoids Glucocorticoids seletive COX2 inhibitors NSAIDs COX1 inhibitors Glucocorticoids immuno suppresents Anti-cancer drugs immuno suppresents Levamisole immuno enhancers Tetramisole immuno enhancers Amino glutithimide Inhibits aromatase enzyme

ABBREVIATIONS

Depolarization- sodium efflux and potassium influx

Repolrisation- potassium efflux and sodium influx

Hyperpolarisation- chloride influx in CNS

GABA- gamma amino butyric acid

PABA- para amino benzoic acid

5HT- 5-hydroxy tryptamine

ACH- acetyl choline

H- histamine

ACE- angiotensin converting enzyme

HMGcoA- beta hydroxy beta methyl glutaryl co A

NA- nor adrenaline

D- dopamine

FFA-free fatty acid

ADP- adenosine tri phosphate

cAMP- cyclic adenosine mono phosphate

COX- cyclooxigenase

ETC- electron transport chain

NN-  cholinergic ganglionic receptor

NO- nitric oxide

NM-  cholinergic neuromuscular receptor(skeleton muscle)

α- alpha adrenergic receptor

β- beta adrenergic receptor

Na- sodium

K- potassium

Cl- chlorine

Ca- calcium

↓- decrease

↑- increase

ω- omega oxidation

Treatment of poisoning

Drug poisoning is a very serious issue. Which can be due many reasons like overdose of a drug or for the intention of suicide and many more reasons. There are different antidotes for different drugs some of them are summarized here. There are 7 common steps for any poisoning treatment.

Universal antidote- tannic acid + magnesium oxide + charcoal solution

                                  tea + toast + magnesium carbonate

Common steps for every poisoning treatment

 can be learn as “GEF and APID”.

1. Gastric lavage- induce vomiting by ipecac and salt solution.

2. Endotracheal intubation- full ventilation or oxygen supply.

3. Forced diuresis- by giving diuretics expell out drug from urine.

4. Alklinisation- ionisation/inactivation and thus preventing absorption of drug.

5. Prophylactic antibiotics- to prevent infection.

6. Intravenous fluids- normal saline with dextrose.

7. Dialysis- heamodialysis and peritoneal dialysis.

8. Antidote- different for each drug

Drug Antidote Morphine Naloxone Lead EDTA, succimer Arsenic BAL, sod thio sulphate, ferric oxide Bismuth BAL (dimercaprol) Mercury BAL, sod. formaldehyde succinate, Organo phosphous compounds Atropine, oximes Iron Desferioxime Copper Penicilamine Paracetamol Acetyl cystiene Benzodiazipenes Flumazenil Anti-coagulants Vitamin k Carbon monoxide Niketamide, diazepam, dexamethasone Ozone Anti-oxidants Cynaide Nitrate compounds Barbiturates Picrotoxin, glutithimide, bemigride, furosimide Digitalis Phenytoin, atropine, antibodies, diazepam Metanol Ethyl alcohol Salicylates Furosemide

SYNDROMES Grey baby syndrome Chloramphenicol over dose in babies Mysthenia gravis Due to NM receptor deficiency Alzimer's disease Deficiency of cholinergic receptors in brain Raynaud's disease Hypertension or high blood pressure Wilson's disease Abnormal copper metabolism and its deposition in stomach & liver Zolinger elison syndrome Peptic ulcer due to gastrin hormone Crohn's disease Ulcer affecting illeum and colon Travelles diarrohea Normal diarrohea (lopramide, doxycycline are the drug of choise) Hepatic coma Osmotic luxative inhibits the growth of NH3 producing bacteria Irritable bowl syndrome Due to constipation & diarrohea gastric motility is affected, pain Steven johnson syndrome Adverse effect of sulfonamides Fanconi syndrome Is a renal toxicity due to adverse effect of tetracycline Flu like syndrome Is a fever due to rifampicin overdose Dwarfism Growth hormone deficiency in childs Symonds disease Growth hormone deficiency in adults Acromegaly Growth hormone over production in adults Gigantism Growth hormone over production in childs Addison's disease Hyposecretion of sex hormones Cushing syndrome Hypersecretion of sex hormones Cretinism Hyposecretion of thyroid hormones in childs Myoxidema Hyposecretion of thyroid hormones in adults Endemic goiter Hyposecretion of thyroid hormones in adults Exopthalmic goiter Hypersecretion of thyroid hormones (bulging of eyes) Hyperglycemia Decreases insulin production, diabetes mellitus results Hyporglycemia Adverse effect of oral hypoglycemics Megloblastic anemia Folic acid deficiency Pernicius anemia Vitamin B12 defeciency Ricketus Vitamin D defeciency Scurvy Vitamin C defeciency Heammorage Vitamin K defeciency Xeropthalmia Vitamin A  defeciency

DRUGS & THEIR SIDE EFFECTS Nsaids Peptic ulcer & vasocostriction Chloramphenicol Grey baby syndrome, bone marrow depression Thizides diuretics Hypokalemia, inhibits insulin secretion Loop diuretics Hypokalemia or low potassium ions concentration Amiloride/triametrene Heperkalemia or high potassium ions concentration Isoniazid Hepatotoxicity & neuropathy Phenothiaznes Goes in to retina (retinopathy) Chlorpromazine Goes in to retina (retinopathy) Quinines Goes in to retina (retinopathy) Phenytoin Acute hydantoin syndrome, cleft palate, hypoplastic nails Sulfonamides Anemia, cystalourea, kernicactus, steven johnson syndrome Amino glycosides Ototoxicity, nephrotoxicity, NM blocker, deafness Floroquinones Inhibits microsomal P450 Omeprazole Inhibits microsomal P450 Dalaverdine Inhibits microsomal P450 Rifampicin Activates microsomal P450 Cigreete Activates microsomal P450 Phenytoin Activates microsomal P450 Alcohol Activates microsomal P450 Barbiturates Activates microsomal P450 Gresiofulvin Activates microsomal P450 Zidovudine Activates microsomal P450 Stavudine Activates microsomal P450 Corticosteroids Supression of adrenal hormones Steroids Peptic ulcer, euphoria, arthritis, cataract, cushing syndrome Probenicid Increases uric acids excretion, decreases penicilin excretion Ephederine Tachyphylaxis or destruction of NA store Dopamine Inhibits prolactin release Metoclopramide Increases prolactin (milk secretory hormone) Domperidone Increases prolactin (milk secretory hormone) Fibrates Increases insulin and kidney stone formation Eno Kidney stone formation after a long use ACE inhibitors Inhibits bradykinin matabolism thus results cough Diazoxide Decreases insulin secretion α2 agonists Decreases insulin secretion Thizides diuretics Decreases insulin secretion Fibrates Increases insulin secretion Heparin Haematoma, thrombocytopenia (platelets defeciency) Tetracycline Complex formation with Ca in teeth, bone weakness, Fanconi syndrome or renal toxicity Pyridoxine Increases levo dopa's metabolism Isoniazid Increases pyridoxine excretion Valproic acid Inhibits barbiturates metabolism Minoxidil Hypertrichosis (hairs on palms) Chloramphenicol Hypothermia, grey baby syndrome, bone marrow depression Paracatamol Hepatotoxicity Morphine Constipation, pin point pupil, depression of lungs Alcohol Mental disturbances and inhibits physical growth Testosterone Musculinization of foetus Bradykinin Cough Substance p Cough and pain Tetracycline Fanconi syndrome or renal toxicity Rifampicin Flu like syndrome or fever Pyrazinamide Hyperuricemia Oral hypoglycemics Hyporglycemia Aspirin Reye syndrome