med chem top 200

opiate agonist
less effect as an analgesic and less respiratory depression than morphine

opiate agonist
equipotent as morphine as an analgesic and cause of respiratory depression and constipation

central analgesic agent
moa - antipyretic activity, direct inhibition of hypothalamic heat regulating center
pain - inhibits prostaglandin synthase in the CNS with minimal peipheral inhibition
Warfarin interactions

anti depressant
triazolopyridine
moa - selectively inhibits serotonin reuptake and potentiates 5-hydroxytryptophan
ind-depression,alcoholism, aggressive behavior, cocaine withdrawal
SE prolonged erections

leukotriene receptor antagonist
ind - chronic asthma
moa - selective and competitive CysLT1 receptor antagonist C3,D4 & E4

PPi
ind - gerd
CYP450 inhibitor
reacemic mixture
humans of asian descent show prolonged plasma levels

s-enantiomer of omeprazole

HMG-CoA reductase inhibitor
compactin class
prodrug activated by liver hydrolysis of the lactone ring
ind - hypercholesterolemia
extensive first pass by CYP3A4
can be taken without regard to meals
80mg/day max

HMG-CoA reductase inhibitor
compactin class
ind - hypercholesterolemia
extensive first pass via sulfation
food decreases absorption
hepatic disease = huge increase in plasma levels

sympathomimetic bronchodilator
short acting
B2>B1
most widely used agent via nebulizer

anti-platelet
oral thienopyridine
moa 1. inhibits ADP
       2. inhibits induction of adhesion receptor
       3. effective for life of platelet
       4. does not inhibit cAMP
ind - reduction of artherosclerotic events associated with MI, stroke, PAD or stents
acute coronary syndrome

HMG-CoA reductase inhibitio
non-compactin
ind - hypercholesterolemia
very minor first pass CYP2C9
2 hr antacid rule
sulfonamide

HMG-CoA reductase inhibitor
non-compactin
ind - hypercholesterolemia
extensive first pass CYP3A4
hepatic disease = increse in plasma levels
take without regard to meals
SE phototoxicity

RAS antagonist
ACEI
use caution in renal failure
ethyl ester prodrug

RAS antagonist
ACEI
100% urinary excretion
reduse dosage by CrCl

anti-depressant
SSRI
enantiopure drug
T 1/2 27-30hs
highly selective
10mg recommended dosage in hepatic impairment

anti-anxiety 3
benzo

central analgesic
non-schedule narcotic agonist
opiod activity
moa - binds mu-receptors and prevents reuptakd of NE and 5HT in the CNS
modify dose if CrCl < 30
watch with CYP2D6 inhibitors

antidepressant
SNRI
potent inhibitor of neuronal 5HT and NE reuptake and a less potent inhibitor of DA
ind - fibromyalgia
off label - stress and urinary incontinence

anti-psychotic
second gen
tabs and orally disintegrating
heavily sedating with less weight gain
thienobenzodiazepine

anticoagulant
vitamin K reductase inhibitor
dosage must be individualized
routine monitoring of INR
watch for signs of bleedin - petechiae
displacement a major cause of DI
do not switch brands
close communication between MD and dentist necessary

most potent enantiomer of warfarin and metabolized by

less potent enantiomer of warfarin and metaboilsm of

antiadrenergic/sympatholytic
selective beta1 blocker
ind - HTN,MI, anging pectoris
reduce dose in renal failure CrCl

antiadrenergic/sympatholytic
selective beta 1 blocker
not FDA approved for CHF but used extensively to prevent cardiac remodeling

calcium channel blocker
1,4 dihydropyridine
ind - HTN,stable and prinzmetals angina
avoid abrupt withdrawal
caution in heptic dysfuntion
pass into mother milk
food interactions - grapefruit juice

diuretic agent
thiazide

antibiotic
beta lactam
aminopenicillin
less diarrhea
oral only
not penicillinase resistant
ped - administer with milk,juice or cold drink

antibiotic
aminopenicillin
penicillinase resistant
take with food if GI upset

antibiotic
macrolide
ind - COPD, one dose Tx for ped otitis media
IV and oral use only, NO bolus or IM
does not inhibit CYP enzymes

antibacterial action
sulfonamide (4)

RAS antagonist
ARB
40-50% food effect on absorption
can cause a 20% increase in serum K levels

non-barbiturate sedative & hypnotic
imidoazopyridine
ind - short term insomnia
moa - non benzo modulation of GABA-BZ receptor

anti-depressant
SSRI
ind - OCD
T 1/2 21 hours
40 mg max for elderly or devilitated pts
caution with withdrawal, may cause severe behavioral symptons

anti-depressant
SSRI
ind - OCD, PTSD
T 1/2 26-104hrs
7 days to reach steady state

diabets med
first drug of choice in TII
moa - decrease hepatic gluconeogenesis & intestinal glucose absorption
does not cause insulin release in the pancreas
watch for MI and septicemia
no protein binding or metabolism with rapid renal excretion

azole antifungal
ind - oropharyngeal vaginal candidiasis
potent inhibitor of CYP3A4, many drug interactions

anti-convulsant
benzo
ind - myoclonic seizures
adult dosage max of 20mg/day

oral diabetes
thiazolidinedione
increases activity of the PPARy, increaseing tissue sensitivity
tightly controlled dispensing
take with or without food
metab by CYP3A4
use alternate BC
monitor ALT

SSRI
ind - ocd, ptsd
tabs
t 1/2 26-104
takes 7 days to reach steady state

adjunct anticonvulsant
ind - adjunct in children 3-12 with partial
management of postherpetic neuralgia
restless leg syndrome in adults
> 12 dose on creatinine clearance
moa - structurally related to GABA but not an agonist

SSRI
ind - ocd, depression, bulimia nervosa
7% of pts will develop a rash, may alter glycemic control in diabetics
t 1/2 - 1-348 h

diuretic acting on thick ascending loop of henle
ind - edema due to CHF
5-sulfamoyl - 2 and 3-aminobenzoic acid

SSRI
genetic markers that link to suicide
QT elongation
ind - social anxiety disorders, panic disorders
t 1/2 - 35h
claim to have favorable side effect profile

fluoroquinoline
DOC for inhalation anthrax
ind - acute sinusitis
admixture incompatable with alkaline solutions

NSAID sulfonamide

NSAID
COX - 2 selective
at therapeutic concentrations no cox -1
use linked to risk of MI

SNRI
phenethylamine
phototsensitivity possible
notify MD if a rash or hives occur

CNS agent for pain relief
structural analog of GABA but does not bind to these receptors or BZ receptors
first drug approved for fibromyalgia
moa - binds a2delta site
metab - negligible in humans
schedule 5 agent, catergory C

skeletal muscle relaxant
not used as adjunct for general anesthesia
centrally acting agent
similar structurally to TCA's
moa - central 5ht descending pathways

antibiotic
1st gen cephalosporin
oral only
>90% excreted renally unchanged

anti-psychotic
2nd gen
ind - schizo
moa - partial agonist at D2 and 5ht1a and antagonist at 5ht2a
SE - orthostatic hypotension