Summary List of most drugs relevant in medical studies

1st pharma test

Atracurium MOA - Competitive
antagonist at neuromuscular
junction
Timolol MOA – non selective β blocker
Open angle glaucoma (↓
intraocular pressure)
Long acting?
Pilocarpine Angle closure glaucoma (↓
intraocular pressure)
Dry mouth
Echothiophate MOA – irreversible AChe
inhibitor
Chronic open angle glaucoma (↓
intraocular pressure)
Pralidoxime Treat organophosphate
intoxication (insecticide)
Atracurium MOA – nondepolarizing block
of NMJ, competes with
acetylcholine
Pancuronium MOA – nondepolarizing block
of NMJ, competes with
acetylcholine
Tubocurarine MOA – nondepolarizing block
of NMJ, competes with
acetylcholine
Suxamethonium MOA – depolarizing block of
NMJ, block acetylcholine
action on muscles, ACh
agonist
Succinylcholine MOA – depolarizing block of
NMJ, block acetylcholine
action on muscles, ACh
agonist
Pyridostigmine Myasthenia gravis
Edrophonium MOA – AChE inhibitor
Dianose myasthenia gravis
(MG)
Short acting


2nd pharma test
Sedative-Hypnotic and Anxiolytic Drugs

, Benzodiazepines
 Alprazolam (Xanax)
 Chlordiazepoxide (Librium)
 Clonazepam
 Diazepam (Valium)
 Lorazepam
 Midazolam
 Triazolam
 Flumazenil
 Flurazepam
Actions

 Reduction of anxiety
 Sedative/hypnotic
 Anterograde amnesia
 Anticonvulsant
 Muscle relaxant
 MOA - Increase frequency of opening of chloride ion channels coupled to GABA A receptors
Therapeutic uses

 Anxiety disorders
 Sleep disorders
 They cause short-term amnesia
 Seizures
 Muscular disorders
Adverse effects

 Drowsiness
 Confusion
 Ataxia (at high doses)
 Cognitive impairment (amnesia and knowledge retention)
 Dependence and withdrawal symptoms
 Agitation
 Insomnia
 Restlessness
 Anxiety
 Tension
 Contraindications
 Liver disease and acute angle glaucoma
 Alcohol and CNS depressants (enhance effects of hypnotics)
Drugs
Benzodiazepines Therapeutic use Adverse effects Adm/duration

,Alprazolam Short & long-term treatment for panic Mainly: poor/decreased Intermediate (10-
disorders (most effective drug) concentration, drowsiness, & 20h)
fatigue, (rare dizziness,
headache,); withdrawal reactions
in 30% of pts
Chlordiazepoxide Acute treatment of alcohol withdrawal Long (1-3 days)
and related seizures
Clonazepam Chronic anxiety treatment; adjunctive Long acc. to
drug for seizures Lippincott (6-12h)
Most effective drug w. alprazolam
Diazepam MOA – binds & facilitates inhibitory Long (1-3 days);
actions of GABA (can be used in
Chronic anxiety treatment; seizure and conj. w.
acute alcohol withdrawal; muscular anesthetics)
spasms (cerebral palsy, multiple
sclerosis)
Lorazepam Chronic anxiety treatment; seizures and Intermediate (10-
acute alcohol withdrawal 20h); (can be used
[Note: safe in pts w. hepatic impairment] in conj. w.
anesthetics)
Midazolam Premedication for anxiety-provoking Short (1-6h); (can
procedures – causes amnesia and be used in conj. w.
sedation anesthetics)
Triazolam Insomnia (pts who cannot fall asleep) Tolerance after few days; severe Short (3-8h)
withdrawal  rebound insomnia;
daytime anxiety, amnesia,
confusion
Flumazenil Reverses effects of benzodiasepines Mainly dizziness, nausea, Only IV, rapid
(antagonist) vomiting, agitation; withdrawal; onset, short
seizure if mixed with TCAs or duration
antipsychotics
Flurazepam Sleep disorders (rarely used) Excessive daytime sedation & Long acting (1-3
accumulation in body days)
(particularly in elderly); mild
withdrawal due to less potency &
slow elimination


Barbiturates
 Amobarbital
 Pentobarbital (also drug of abuse)
 Phenobarbital (Luminal)
 Thiopental (Pentothal)
Actions

 Depression of CNS – sedation, hypnosis, anesthesia, coma, death

,  Respiratory depression
Therapeutic use

 Anesthesia
 Anticonvulsant
 Sedative/hypnotic
Adverse effects

 Impaired concentration, drowsiness
 Enzyme induction (P450) – quicker metabolism of certain drugs
 Apnea, coughing, chest wall spasm, laryngospasm, and bronchospasm
 Dependence/withdrawal symptoms
 Tremors
 Anxiety
 Weakness, restlessness
 Nausea, vertigo
 Seizures, delirium
 Cardiac arrest
 Contraindications - acute intermittent porphyria
Barbiturates Therapeutic use Adverse effects Adm/duration
Amobarbital Short (3-8h)
Pentobarbital Anesthetic (blocks high- Short (3-8h)
frequency Na+ channels)
Phenobarbital MOA – blocks Na & Cl Cognitive impairment Long (1-2 days)
channels  enhances GABA in children and adults
inhibition of glutamate ↑ metabolism of ↑ Hepatic metabolism
receptors hormonal of many hepatic drugs
Anticonvulsant: Chronic contraceptives
management of tonic-clonic
seizures;
(Refractory) Status epilepticus
when other drugs fail
Thiopental IV anesthetic, weak analgesic Can cause severe Rapid onset, ultra-short
hypotension in pts. w. action (20 min)
hypovolemia/shock


Antihistamines
 Diphenhydramine (Benadryl)
 Doxepin
 Hydroxyzine (Atarax)
Actions

 Sedation