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Transcript
Drug
Main action
Side effects
Notes
Neuromuscular blocker:
-Curare
-D-Tubocurarine (the
reactive gradient of
Curare)
Block cholinergic
transmission (Ach). So
they’re used in:
Surgeries, Intubation, ECT,
ICU and orthopedic
procedures.
-Histamine release
- Bronchoconstriction and
↑ Mucus secretion.
- ↑HR.
-Hypotension.
- Ganglion blockade.
- Non-depolarizing
blockers.
- Competitive (antagonists).
- To reverse their action we
↑ Ach by giving AchE
inhibitor.
- Given IV.
- Doesn’t penetrate
membranes or BBB.
- Excreted unchanged.
- Calcium channel blockers
and aminoglycosides
enhance their action.
- Depolarizing blocker.
- Agonist that leads to
desensitization of the
receptor.
- Doesn’t respond to AchE.
-Short onset of action.
- Given IV.
- Doesn’t penetrate
membranes or BBB.
- Excreted unchanged.
- Given orally except
Dantroline is given IV in the
urgent situations.
Neuromuscular blocker:
- Succinylcholine
“suxamethonium”
Block cholinergic
transmission (Ach). So
they’re used in:
Surgeries, Intubation, ECT,
ICU and orthopedic
procedures.
- Hyperkalemia.
- Malignant Hyperthermia
(we use IV dantroline to
reverse this).
- Post-operative pain.
Spasmolytic drugs:
On CNS:
Diazepam (facilitate GABA)
Baclofen (GABA agonist)
Tizanidine (Reinforce)
On skeletal muscle:
Dantroline (Ca+2 blocker)
DMARD aka SAARD:
Methotrexate
Cerebral palsy.
Multiple sclerosis.
Stroke with spasms.
- GI effects.
- Sedation.
- RA and Psoriatic arthritis
- Antineoplastic
- Immunosuppression
-GI effects
-Mouth ulcers, Stomatitis
-Leucopenia
-Hepatotoxicity
-Teratogenic
- Low doses, once weekly.
- Cotrimoxazole has
synergistic effect with it
-NSAID increase its
elimination
-4-6 weeks for its effect
Chloroquine and
Hydrochloroquine
- Antimalarial
- Slow the progression of
RA
-GI effects
-Blurring vision
-Urticaria
-Hemolysis
-Given in combination with
NSAID or Methotrexate
Sulfasalazine
- RA
- Ulcerative colitis
-Hemolytic anemia
-Infertility
- 2-3 months for its effect
- More toxic than
Methotrexate
- Used in refractory cases
TNF inhibitors:
Entanercept
Infliximab
- Moderate to severe RA
- Immunosuppression so
the body is prone to
infections
- Combined with
methotrexate
- Antibiotic and
vaccinations are given with
it
Acetaminophen
(paracetamol)
- Early RA to decrease pain
“analgesic and antipyretic”
- Poison Ivy
- Toxic in high doses.
- N-acetylcysteine is the
antidote
NSAIDs
Ex: aspirin
- RA
“analgesic, antipyretic and
anti-inflammatory”
- LT (Zafrilukast) inhibitor
are given with it in
asthmatic patients (any
allergy, ex: Urticaria).
- Celecoxib are used instead
of NSAID in patients with
peptic ulcer
Bacitracin
- staph aureus infections
- +ve bacteria
-GI effects
-Peptic ulcers
- no ptt aggregation
- PDA closure
- Asthmatic patients
worsening
- Reye’s syndrome “only
with aspirin”
- When it’s used
systemically it has side
effects
- rarely cause
hypersensitivity
Polymyxin B
- -ve bacteria
- side effects “systemically
use”
- Inhibits membrane
synthesis
Neomycin and Gentamycin
- gram negative aerobes
and some anaerobes
*was not mentioned*
- ototoxicity and nephron
toxicity “systemically use”
- May cause
hypersensitivity
- Topical
- Oral in GI infections
- Inhibits proteins synthesis
Neosporin = Bacitracin +
polymyxin B + Neomycin
- wide spectrum:
gram positive, negative and
anaerobes
Benzoyl Peroxide
- First line in mild cases of
Acne
Salicylic acid
- First line in mild cases of
Acne
- Chemical burns
- Metabolite of aspirin
- MOA:
1- decrease inflammation
2- Keratolytic
Retenoids
Topical: Tezarotene and
adapalene
Systemic: Isotretinoin
- First line nowadays in
Acne
- Also used in Psoriasis
Topical: teratogenic “not a
concern”
Systemic: Teratogenic and
cause chelitis
- Vit.A analogue
- Control epithelial cells
growth
- Ointment/ Topical
- inhibits cell wall synthesis
- No resistant against it
- Used in combination with
antibiotics
Tetracycline:
Minocycline and
Doxycycline
Clindamycin
- Acne
- Discoloration of teeth and
bone
- Don’t give it to children
- Given orally
-Acne
- Anaerobic bacteria
- pseudomembranous
colitis
- Topical
Erythromycin
-Acne
Azoles:
Imidazoles *bad drugs*
ex: Ketoconazole
Triazoles *most common*
ex: fluconazole+ itracon-
- Against fungal infections
Allylamines:
naftifine
terbinafine.
- Onychomycosis
- MOA: inhibits ergosterol
synthesis
Nystatin
- Against fungal infections
- Attacks ergosterol directly
Griseofulvin
- Against fungal infections
- Inhibits mitosis
Acyclovir
Penciclovir
- Against viral infections.
- Inhibits viral replication.
- Has low bioavailability so
it’s found as creams
- Can be given orally
Premethrin
- DOC in parasitic infections
“first line”
- Apply before going to bed
for about 14 hours.
Lindane
- Second line in parasitic
infections
Rifampicin
- Leprosy treatment
- Once a month
Dapsone
- Leprosy treatment
- Once daily
Clofazimine
- Severe cases of leprosy
Topical Corticosteroids:
Hydrocortisone
-Psoriasis
-Eczema
-Poison Ivy *in severe cases
we use systemic*
-Bites
- Burning sensation
- Adrenal gland suppression
- Atrophy of the dermis and
epidermis
- Hypopigmentation
- Steroid acne
- Anti-inflammatory
- Anti-proliferation
- immunosuppression
Vit.D analogues:
Calcipotriene, calcitriol
- Psoriasis
- Hypercalcemia
- Inhibits epidermal
proliferations
- Stimulates differentiation
- Given with benzoyl
peroxide
- Staphcoccus is resistant to
it
- Imidazoles disrupts
steroids synthesis
- Neurotoxic
- Can be given orally
- MOA: inhibits ergosterol
synthesis
- Found in shampoos and
lotions
PUVA
- Psoriasis
Immuno-modulator:
Tacrolimus
- Eczema
Antihistamine first
generation:
Diphenhydramine
Chlorpheniramine
(Allerfin)
Hydroxyzine
Promethazine
Antihistamine second
generation:
Loratadine
Cetirizine
- Relax eczema patients
-Skin cancer
- Effusions
- Sedation
*it’s a SE but it’s why I use it
in eczema*
- Urticaria
- Peptic ulcer
- Bites
,‫مجد بن الهيثم‬
.‫النادي الطبي‬