Generic Name Common Clinical Utility Mechanism of action Unique Toxicity

Acetaminophen Tylenol

Allopurinol anti-hyperuricemic drug

Alprazolam Xanax GABA receptor agonist

Amino(theo)phylline Tx of bronchial asthma "narrow therapeutic window"

Amiodarone

Amoxicillin hypersensitivity reactions

Amphotericin B nephrotoxicity

Aspirin NSAID, inhibits COX

Atropine

Azidothymidine (AZT) bone marrow suppression

Azithromycin rash in mono (like ampicllin)

Bleomycin pulmonary fibrosis

Bromocriptine

ACE inhibitor

Trade "common" name

antipyretic/analgesic, no anti-inflammatory activity, DOC for children with viral infx

inhibits PG synthesis in CNS (post. Hypothalamus)

centrilobular hepatic necrosis (can be countered with N-acetyl cysteine)

inhibits xanthine oxidasehypersensitivity reaction, skin rash

benzo of choice for panic disorders, Tx of agoraphobia

addiction (with protracted withdrawl)

PDE inhibitor, results in higher conc of intracellular cAMP

Tx of life-threatening supraventricular and ventricular tachyarrhythmias

Class III antiarrhythmic, increases AP duration and refractory period

pulmonary fibrosis, pts may see halos in periphery d/t corneal deposits

for non-penicillinase producing strains of Strep, Staph, H. flu, E. coli, P. mirabilis, uncomplicated GC infx, otitis media

beta lactam antibiotic which inhibits bacterial cell wall synthesis

DOC for systemic mycosespolyene antifungal, binds to membrane ergosterol to induce pore formation

Acdetylsalicylic Acid (ASA)

anti-inflammatory/antipyretic, DOC for RA

GI bleeding, Reye's syndrome

to increase HR and for Tx of cholinesteraase inhibitor-induced toxicity

competitive muscarinic receptor blocker

insufficient dose may cause paradoxical slowing of HR

Zidovudine, Retrovir

part of highly active antiretroviral therapy (HAART), Tx of HIV/AIDS

nucleoside inhibitor (T analog) or reverse transcriptase, terminates viral DNA synthesis

antibacterial, DOC or C. trachomatis urethritis, Tx of legionella, Neisseria and Mycoplasma infx

macrolide antibiotic, bacteriostatic, binds 50s ribosomal subunit, blocks translocation

antineoplastic agent, expecially for Tx of testicular tumors

attacks phosphodiester bonds of DNA, causing strand breakage

anti-Parkinsonism drug, Tx of hyperprolactinemia

dopamine receptor agonist exacerbates psychiatric ilness

Captopril/enalapril/lisinopril

anti-hypertensive, Tx of CHF, post MI therapy

dry cough, angioedema, fetal damage

Ceftriaxone

Chloroquine

Chlorothiazide hypokalemia

Chlorpromazine

Cholestyramine Questran

Cimetidine/ranitidine Tagamet PUD, GERD, Z-E syndrome

Ciprofloxacin

Clindamycin, lincosamide

Clonidine alpha 2 adrenergic agonist sexual dysfunction

Clozapine agranulocytosis

Cocaine topical anesthetic in the nose and throat

Colchicine antineoplastic agent, gout

Cromolyn sodium only minimal systemic toxicity

active against G- infx (nosocomial, Lyme, N. gonorrhoeae) and bacterial meningitis

3rd gen. cephalosporin, beta-lactam inhibitor of cell wall, blocks terminal cross-linking of bacterial cell wall peptidoglycan ad activates cell wall autolytic enzymes

can cause a positive Coombs' test

DOC against flaciparum malaria, Tx of extraintestinal amebiasis (esp hepatic amebiasis)

antimalarial drug, inhibits breakdown of heme in the plasmodial digestive tract

antihypertensive, used for CHF, nephrotic syndrome, hypercalciuria

prototype thiazide diuretic, binds Cl- channel in DCT, inhibits NaCl reabsorption

low potency drug for Tx of schizophrenia or psychiotic symptomatology

neuroleptic agent, antagonist at a1-adrenergic, dopamine, 5HT receptors in CNS

contraindicated in pts with seizure disorders

antihyperlipidemic used for type IIa and IIb hyperlipidemias

anion exchange resin which binds negatively charged bile acids and bile salts, dec enterohepatic recirculation and inc their excretion

constipation and impaired absorption of fat-soluble vitamins

prototype H2 receptor antagonist, reversibly binds to gastric parietal cells and inhibits acid secretion

inhibits cyto p450, increased conc of other drugs and may have antiandrogenic effects

G- infx, gonorrhoeae, UTIs, soft tissue infx, diarrheal diseases

inhibition of bacterial DNA gyrase

pediatric Achilles tendon rupture

anaerobic bacterial infx (lung abscesses, intra-abdominal infx, orthopedic infx)

irreversibly binds 50s subunit, interfering with aa transfer

may cause pseudomembranous enterocolitis

HTNj, opiate withdrawla, benzo withdrawal

refractory schizophrenic pts or tardive dyskinesia

neuroleptic agent with high affinity for 5HT2 and D4 recept

inhibits reuptake of catecholamines

strong abuse potential, respiratory depression and coronary spasm

plant alkaloid, binds tubulin, causes depolymerization of microtubules

peripheral neuritis, alopecia

prophylactic anti-inflammatory in asthma

inhibits mast cell degranulation

Cyclophosphamide hemorrhagic cystitis

Cyclosporine nephrotoxicity

Diazepam Valium GABA receptor agonist

Diethylstilbestrol via steroid hormone mechanism

Digoxin

Diltiazem generally safe

Diphenhydramine Benadryl minor abuse potential

Dobutamine quite safe in lower doses

Doxorubicin antineoplastic agent cardiotoxicity

Edrophonium Tensilon Dx of MG

Epinephrine

Erythromycin

Estrogen via steroid hormone mechanism

autoimmune disorders and bone marrow transplants

alkylating agent, activated by cyto p450 and then alkylates DNA

immunosuppressant, prevents rejection of allergenic transplants, tx of graft vs host disease and selected autoimmune disorders

synthesis IL-2 by activated T-cells

anxiety, skeletal muscle relaxant, preanesthetic med, status epilepticus

addiction (with protracted withdrawl)

morning after pill, can be used to prevent pregnancy when at high doses

rare, clear cell cervical or vaginal adenocarcinoma among daughters of women who took it during early pregnancy

CHF, A-V nodal depression, a-fib and flutter

reversibly binds and inhibits Na/K ATPase, positive inotropy

life-threatening cardiac arrhythmias

angina from vasospasm, Tx of arrhythmias (SVTs) and mild-moderate HTN

Class IV antiarrhythmic drug, Ca channel blocker

DOC for urticaria and allergic rhinitis, Tx of insomnia

1st generation antihistamine (H1 receptor blocker)

CHF, promotes inc cardiac output with little change in myocardial O2 demand

Beta 1 adrenergic receptor agonist

anthracycline antibiotic which intercalates DNA, binds to cell memb and generates O free radicals through lipid peroxidation

competitive inhibitor of acetylcholinesterase

only as may relate to brevity of effect

DOC for anaphylaxis, used in asthama, cardiac arrest, enhances effect of local anesthetics

alpha and beta adrenergic agonist

excessive dosing may precipitate hypertensive crisis

alternative to PCN in allergic pts, 1st choice for Legionella and M. pneumoniae, 2nd choice for Syphilis and Chlamydial

macrolide antibiotic, binds 50s ribosomal subunit interfering with protein synthesis, blocks translocation

sensorineural hearing loss in large doses, inhibition of cyto p450

OCPs, HRT, primary hypogonadism and hypopituitarism, dysmenorrhea, dysfunctional uterine bleeding, palliative Tx for prostatic carcinoma

thromboembolic phenomena

Finasteride BPH and male pattern bladness

Fluoxetine SSRI

Folic acid ~

Furosemide Lasix

Gentamicin ototoxicity and nephrotoxicity

Haloperidol Haldol

Heparin thrombocytopenia

Hydralazine

Ibuprofen Advil analgesic, anti-inflammatory, antipyretic NSAID, inhibits COX nephrotoxicity

Imipramine severe major depression

Indinavir sulfate part of HAART for HIV/AIDS thrombocytopenia

Indomethacin

5-alpha reductase inhibitor, inhibits conversion of testosterone to DHT in target tissues

gynecomastia for Proscar, not Propecia

depression, panic disorder, OCD, PTSD and bulemia nervosa

inhibits cyto p450, potentially fatal 5HT syndrome when combined with MAOIs

folate defic, dietary supplement for women of childbearing age to prevent NTDs

cofactor which participates in 1 carbon transfer for DNA and methionine synthesis

CHF, pulm edema, renal and liver failure, severe HTN, hypercalcemia

protoype loop diuretic, inhibits reabsorption of Na, K and Cl in ascending thick limb by blocking Na/K/Cl cotransporter

hypokalemia, ototoxicity, allergic interstitial nephritis

G- bacteria, for serious infx, topically in burns infected with Pseudomonas and ocular infx

irreversibly binds 30s ribosome, inhibiting the initiation of protein synthesis

psycotic symptoms or schizo, severe manic or agitated episodes, Tourette's

dopamine receptor antagonist (esp D2) in mesolimbic and mesocortical areas

may cause Parkinsonism, akathisia, dystonia, tardive dyskinesia, hyperprolactinemia, neuroleptic malignant syndrome

in pts at high risk for thrombosis and pulm emboli, used to stop ongoing thrombosis, used in acute phase of MI

accelerates antithrombin III binding to thrombin and antithrombin III, inactivates thrombin, Ixa, Xa, XIa, XIIa and kallikrein, inhibits clot formation, does not dissolve clots!

moderate-severe essential HTN, CHF (in combo with oral nitrates)

direct relaxation of vascular smooth muscle, greater effect on arterioles than venules

lupus-like syndrome with +ANA (in slow acetylators)

prototype tricyclic antidepressent, decreases reuptake of NE and 5HT in the CNS

antimuscarinic effects, orthostatic hypotension

inhibits viral protease, preventing formation of functional reverse transcriptase

closure of PDA, moderate-severe RA, OA, ankylosing spondylitis, Bartter's synd, tendinitis, bursitis, acute gout, dysmenorrhea, DOC for Reiter's

NSAID, inhibits PG-forming COX

blood dyscrasias, hepatotoxicity, contraindicated in pregnant women

Insulin, regular hypoglycemia

Isoniazid (INH) tx and prevention of TB

Isoproteronol bronchial asthma, bradycardia beta agonist sinus tachycardia

Isotretinoin teratogenic

Ketoconazole

Levodopa

Levothyroxine ~

Lidocaine

Lithium mania, depression, bipolar disorder

Losartan K+ HTN fetal damage

Lovastatin Mevacor HMG-CoA reductase inhibitor

Meperidine Demerol analgesic opioid receptor agonist relative mydriasis

IDDM, NIDDM, diabetic ketoacidosis, hyperosmolar hyperglycemic nonketotic coma

binds tyrosine kinase receptors on cell surface, promoting anabolic reactions withing target cells, promotes translocation of GLUT transporters to plasma memb

inhibits mycolic acid synthesis of mycobacterial cell wall

lupus-like syndrome with +ANA (in slow acetylators)

severe cystic acne that is recalcitrant to standard therapy

unknown (may inhibit sebaceous gland size and function)

coccidiomycosis, histo, blasto, paracoccidio, mucocutaneous candidiasis

blocks synthesis of fungal cell membrane ergosterol

suppression of cyto p450 (be careful of any patient taking Warfarin, etc..)

for Parkinson's disease (usually with carbidopa)

dopamine precursor (converted by dopa decarboxylase)

hyperkinetic movement disorders, psychotic behavior

DOC for hypothyroidism

activation of nuclear non-histone protein receptors attached to DNA, increasing trnascription of mRNA

primary therapy for ventricular arrhythmias, local anesthetic

decreases automaticity in Purkinje fibers and vent tissue by blockin inactivated Na+ channels, favoring phase III repolarization

cimetidine and propranolol increase its toxicity

antidepressent effect - may decrease supersensitivity of dopamine receptors, increase Ach, enhance 5HT activity for depression; antimania effect - it may prevent recycling of phosphoinositides, causing depletion of IP3 and DAG, diminishes excess catecholamines and 5HT

teratogenic, interstitial nephritis, nephrogenic DI

angiotensin II receptor blocker

Type Iia and Iib hyperlipoproteinemia and secondary hyperlipoproteinemia

elevated liver enzymes, rhabdomyolysis

Methotrexate

Methylphenidate

Metoprolol/lopressor HTN, tachyarrhythmias, heart disease ~

Metronidazole

Morphine sever pain

Nafcillin penicillin-resistant Staph and Strep infx

Naloxone acute opioid overdose ~

Nifedipine Ca channel blocker Raynaud's phenomenon

Nitroglycerine

Nitroprusside thiocyanate poisoning

Octreotide somatostatin analog ~

Omeprazole GERD, PUD, Z-E syndrome ~

Phentolamine hypertensive crisis associated with pheo orthostatic hypotension

Phenoxybenzamine

anti-neoplastic agent, RA, abortion, ectopic pregnancy, psoriasis

folic acid analogue, blocks DHF reductase, results in decreased dTMP -> decreased DNA and protein synthesis

pneumonitis, fatty liver, myelosuppression

CNS simulant, stimulates mood and alertness and depresses apetite, Tx of ADHD

stimulates release of catecholamines (cross the BBB)

significant abuse potential in non-ADHD subjects

Beta 1 adrenergic receptor blocker

amebic infx, DOC for trichomoniasis and giardiasis, Bacteroides fragilis, C. diff, Gardnerella vaginalis

entry into cells of infectious organism, chemically reduced and products cause death by interaction with DNA and interfering with cell division

disulfiram-like reaction with alcohol consumption, avoid in pregnant women

primary activity at opioid mu receptors

contraindicated with sedative hypnotics, MAOIs and antipsychotics

beta-lactam antibiotic, inhibits bacterial synthesis by preventing peptidoglycan cross-linking, penicillinase resistant

acute tubulo-interstitial nephropathy (ATIN), though much less than methicillin

opioid receptor antagonist with very high affinity at mu receptors, can also block kappa and delta

mild-moderate HTN, coronary vasospasm

angina, coronary vasospasm, Prinzmetal's angina, CHF, short term management of HTN

coronary vasodilation and systemic venous pooling to reduce preload and vasodilation, d/t metabolism to NO -> activate guanylate cyclase -> cGMP

postural hypotension, reflex tachycardia

hypertensive emergencies, acute CHF, sever mitral regurgitation with pulmonary congestion

directly relxes vascular smooth muscle via NO, relaxes both arterioles and venules

controls excessive horomone secretion in acromegaly, glucagonemia, insulinoma

irreversibly inhibits the gastric parietal cell H+/K+ ATPase

competitive and reversibly blocks alpha adrenergic receptors

pheo, hypertensive crisis secondary to MAO OD, prophylaxis for Raynaud's

irreversibly blocks alpha adrenergic receptors by covalent attachment

inhibits ejaculation, may cause orthostatic hypotension

Phenylephrine tissue necrosis

Phenytoin

Physostigmine glaucoma cholinesterase inhibitor ~

Pilocarpine ~

KCL antiarrhythmic Tx of hypoalemia

Praziquantel eosinophilia

Prednisone

Procainamide

Propranolol HTN, angina, arrhythmias post-MI

Propylthiouracil (PTU) thyrotoxicosis

Quinidine

Sildenafil citrate ED inhibits phosphodiesterase

Spironolactone gynecomastia

nasal decongestant, hypotension, to prolong local anesthetic, to terminate paroxysmal atrial tachycardias, mydriatic

alpha 1 adrenergic receptor agonist

for epilepsy except absence seizures, trigeminal neuralgia, limited use as an antiarrhythmic

inhibits voltage-gated Na channels

gingival hyperplasia, hirsutism

topically for narrow and open-angle glaucoma to reduce IOP

direct-acting muscarinic receptor agonist

involved in maintenance of cellular membrane potential

death if given too quickly as bolus, arrhythmias

DOC for ALL trematode infx, active in cestode infx

antihelminthic, increases memb permeability of susceptible worms to Ca -> paralysis of parasite

anti-inflammatory and immunosuppressant agent, when lon-term therapy is needed

enters target cells and binds to cytosolic receptor, complex is translocated to nucleus, regulates protein synthesis

exogenous Cushing's syndrome

atrial and ventricular arrhythmias, including ventricular ectopic beats

Class IA antiarrhythmic, blocks Na+ channels, thereby slowing rate of phase O depolarization and conduction

lupus-like syndrome with +ANA

beta adrenergic receptor antagonist

use with caution in diabetics, may cause impotence

inhibits thyroid peroxidase-catalyzed reactions, also inhibits peripheral deiodination of T4->T3

maculopapular pruritic rash, agranulocytosis

atrial and ventricular arrhythmias, including ventricular ectopic beats

Class IA antiarrhythmic, blocks Na+ channels, thereby slowing rate of phase O depolarization and conduction, also blocks muscarinic and alpha 1 receptors

patient must be pretreated with b-blocker, digitalis or Ca channel blockers to avoid possible increase in vent response to atrial flutter, may cause Torsades and cinchonism

affects color vision causing difficulty in blue/green discrimination

in combo with K+ losing diuretics to maintain proper K+ balance, useful in presence of high aldosteone levels, used in Dx and Tx of primary hyperaldosteronism, used in Tx of PCOD and female hirsutism

blocks aldosterone action by competitively binding to its receptor

Streptokinase hemorrhagic stroke

Tamoxifen ~

Terfenadine

Thalidomide unknown teratogenic, causes phcomelia

Tranylcypromine monoamine oxidase inhibitor

Vancomycin

Vasopressin central DI ~

Verapamil Ca channel blocker significant negative inotrope

Warfarin Coumadin warfarin skin necrosis

Zafirlukast asthma hepatotoxicity

Zileuton asthma

Tx of DVTs, PE, unclogging of catheters and shunts, acute MI, hypersensitivity reactions, anaphylaxis

no enzymatic action, forms complexes with plasminogen, which can then cleave free plasminogen into plasmin

reduce recurrence of estrogen-receptor-positive breast cancer, particularly in postmenopausal women

competative antagonist to estrogen at receptors in the breast, partial agonist at other estrogen receptors

prevent or Tx symptoms or allergic reactions, without causing drowsiness

H1 receptor blocker (2nd generation antihistomine)

metabolism is easily inhibited by many hepatic microsomal enzyme inhibitors, high conc can cause Torsades

sedative, immunomodulatory actions, recently reintroduced for Leprosy, skin manifestations of lupus

depression, phobias, narcolepsy, panic attacks

avoid tyramine-containing foods

Trimethoprime/ Sulfamethoxazole

UTIs, shigellosis, salmonellosis, H.flu resp infx, Strep pneumo, PCP, typhoid and paratyphoid fevers, Isospora belli

acts as inhibitor of two sequential steps in synthesis of folic acid, sulfa inhibits PABA incorporation into folic acid, triemth inhibits the reduction of DHF to THF

Steven-Johnson syndrome, blood dyscrasias

G+ only, for C. diff psudomembranous colitis, MRSA, enterococcal infx in PCN allergic pts, PCN-resistant pneumococci, w/ gentamicin for S. faecalis and S. viridans endocarditis

inhibits cell wall synthesis by binding to D-Ala-D-Ala, thus preventin its incorporation into peptidoglycan

rapid infusion may cause facial and neck erythema ("red man syndrome"), ototoxicity, nephrotoxicity

increases water reabsorption in the collecting ducts of the kidney by binding to ADH receptor

mild-moderate Htn, SVTs, migraine headache prophylaxis

simialr to heparin, but not useful for rapid anticoagulation

derivative of Coumarin, interferes with synthesis of vitamin K-dependent clotting factors (II, VII, IX, X, protein C, protein S)

leukotriene receptor antagonist (LTD4)

5-lipoxygenase inhibitor, blocks arachidonic acid -> leukotrienes