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Cardiff formulary
Cardiff formulary for years 1, 2 and 3
| Question | Answer | Type |
|---|---|---|
| oxygen | Essential element in respiratory process | Oxygen |
| thiopental | Binds at distinct binding site associated with Cl - ionopore at GABAA receptor, increasing time that Cl - ionopore is open. Post-synaptic inhibitory effect of GABA in thalamus therefore prolonged. | General anaesthetic |
| lidocaine (1) | Stabilizes neuronal membrane by inhibiting ionic fluxes in the fast gated sodium ion channels required for initiation and conduction of impulses thereby effecting local anaesthetic action. | Local anaesthetic |
| lidocaine + epinephrine (adrenaline) (2) | Addition of adrenaline prevents distribution of lignocaine from injection site and thus prolongs duration of local anaesthetic action | Local anaesthetic |
| atropine (1) | Antimuscarinic (anticholinergic) acting as a competitive antagonist of the muscarinic acetylcholine receptors.(Acetylcholine is the main neurotransmitter used by the parasympathetic nervous system). | Preoperative medication and sedation for short-term procedures. Mydriatics |
| diazepam (1) | Benzodiazepine, enhancing GABA activity by acting at the benzodiazepine,-GABA receptor complex to produce sedation | Benzodiazepine. Pre-op medication, sedative, anti-anxiety, anti-convulsant |
| morphine (1) | Opioid which acts as agonist, predominantly at the µ- opioid receptor to relieve pain | Opiate |
| acetylsalicylic acid (1) | Reduces pain and inflammation by irreversibly inactivating cyclooxygenase (COX) enzyme, thus suppressing the production of prostaglandins and thromboxanes | NSAID |
| ibuprofen (1) | Reduces pain and inflammation by reversibly inactivating cyclooxygenase (COX) enzyme, thus suppressing the production of prostaglandins . (naproxen acts similarly) | NSAID |
| paracetamol (1) | Thought to act primarily in the CNS, increasing pain threshold by inhibiting COX-1 and COX-2, enzymes involved in prostaglandin synthesis. Does not inhibit cyclooxygenase in peripheral tissues, so produces no peripheral anti-inflamm effects or GI toxicity | Non-opioid analgaesic |
| codeine (1) | Opioid which acts as agonist predominantly on the µ- opioid receptor to relieve pain | Opioid |
| allopurinol (3) | Reduces synthesis of uric acid by competitive inhibition of xanthine oxidase. Also converted to alloxanthine by xanthine oxidase, which remains in the tissue for ages, is non-competitive inhibitor of the enzyme and produces most of therapeutic effect. | Gout medication |
| methotrexate (3) | Immunomodulator and inhibitor of tetrahydrofolate dehydrogenase, thus preventing formation of tetrahydrofolate that is necessary for synthesis of thymidylate, an essential component of DNA. | DMARD |
| cetirizine (3) | Competes with histamine for the normal H1-receptor sites on effector cells of the gastrointestinal tract, blood vessels and respiratory tract. Penetrates CNS less well than chlorpheniramine so less sedating. | Antihistamine |
| chlorpheniramine (1) | Competes with histamine for the normal H1-receptor sites on effector cells of the gastrointestinal tract, blood vessels and respiratory tract. | Antihistamine |
| dexamethasone (3) | Binds with high affinity to specific cytoplasmic receptors to produce inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, and suppression of humoral immune responses | Used in anaphylaxis and allergy Corticosteroid |
| adrenaline (epinephrine) (1) | Non-selective agonist of all adrenergic receptors (α1, α2, β1, and β2) to different extents | Used in anaphylaxis and allergy, Anti-arrhythmic, mydriatic, bronchodilator used in asthma |
| hydrocortisone (1) | Binds with high affinity to specific cytoplasmic receptors to produce inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, and suppression of humoral immune responses | Used in anaphylaxis and allergy, corticosteroid, anti-pruritic |
| prednisolone (1) | Binds with high affinity to specific cytoplasmic receptors to produce inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, and suppression of humoral immune responses | Used in anaphylaxis and allergy Corticosteroid |
| charcoal, activated (3) | Adsorbs several drugs and toxins, and used in treatment of poisoning with certain agents | Anti-poisoning general |
| acetylcysteine (2) | Protects against paracetamol overdose-induced hepatotoxicity, partly by maintaining or restoring hepatic concentrations of glutathione in early stages, and also by other effects at later stages | Anti-poisoning specific- pracetamol |
| atropine (1) | Antimuscarinic (anticholinergic) acting as competitive antagonist at muscarinic acetylcholine receptors. (Acetylcholine is main neurotransmitter used by parasympathetic nervous system) | Anti-poisoning specific- organophosphates |
| naloxone (1) | Competitive antagonist at opioid receptors, binding to the three main three opioid receptors (mu, delta and kappa) but strongest binding is to mu receptor. | Anti-poisoning specific- opioid |
| phenobarbital (2) | Acts on GABAA receptors, increasing synaptic inhibition. | Anti-convulsant |
| phenytoin (diphenylhydantoin) (2) | Acts on Na+ channels on neuronal cell membrane, limiting spread of seizure activity and reducing propagation. By promoting Na+ efflux from neurons, phenytoin stabilizes threshold against hyperexcitability. | Anti-convulsant |
| amoxicillin (2) | Interferes with synthesis of bacterial cell wall peptidoglycan. After attachment to penicillin-binding proteins on bacteria, inhibits transpeptidation enzyme that cross-links peptide chains attached to backbone of peptidoglycan. not effective orally. | beta-lactam antibiotic |
| amoxicillin + clavulanic acid (co-amoxiclav) (3) | See above. Clavulanate competitively and irreversibly inhibits wide variety of beta-lactamases produced by certain bacteria, making drug combination more potent. | beta-lactam antibiotic |
| benzylpenicillin (2) (Pen.G) | Interferes with synthesis of bacterial cell wall peptidoglycan. After attachment to penicillin-binding proteins on bacteria, inhibits transpeptidation enzyme that cross-links peptide chains attached to backbone of peptidoglycan. not effective orally. | beta-lactam antibiotic |
| flucloxacillin (3) | See benzylpenicillin. Flucloxacillin stable against hydrolysis by variety of beta-lactamases, including penicillinases, and cephalosporinases and extended spectrum beta-lactamases | beta-lactam antibiotic |
| phenoxymethylpenicillin (2) (Pen.V) | Interferes with synthesis of bacterial cell wall peptidoglycan. After attachment to penicillin-binding proteins on bacteria, inhibits transpeptidation enzyme that cross-links peptide chains attached to backbone of peptidoglycan. EFFECTIVE orally. | beta-lactam antibiotic |
| Cefotaxime (3) | Inhibition of cell wall synthesis via affinity for penicillinbinding proteins (PBPs). Displays resistance to penicillinases and so useful to treat infections resistant to penicillin derivatives (also cefuroxime) | beta-lactam antibiotic |
| ciprofloxacin (2) | Bacteriocidal effects due to inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV, which are required for bacterial DNA replication, transcription, repair, and recombination. (also levofloxacin) | Antibacterial |
| clarithromycin (2) | Reversibly binds to t50 S subunit of bacterial ribosomes or near “P” or donor site so that binding of tRNA to the donor site blocked. Translocation of peptides from the acceptor to the donor site prevented, and subsequent protein synthesis inhibited | Antibacterial |
| gentamicin (2) | Irreversibly binds to specific 30S-subunit proteins and 16S rRNA. This leads to misreading of mRNA so incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides. | Antibacterial |
| metronidazole (2) | Reduced metronidazole disrupts DNA's helical structure, inhibiting bacterial nucleic acid synthesis and resulting in bacterial cell death. | Antibacterial |
| nitrofurantoin (3) | Inhibits bacterial acetyl-coenzyme A, interfering with organism's carbohydrate metabolism. Can also disrupt bacterial cell wall formation. | Antibacterial |
| oxytetracycline (3) | Reversibly binds to 30S ribosomal subunit and prevents amino-acyl tRNA from binding to the A site of the ribosome, inhibiting translation and thus cell growth | Antibacterial |
| trimethoprim (2) | Binds to bacterial dihydrofolate reductase, subsequently interfering with uptake of p-aminobenzoic acid (PABA) into folic acid. | Antibacterial |
| vancomycin (3) | glycopeptide antibiotic which acts by inhibiting cell wall synthesis. | Antibacterial |
| ethambutol (3) | Inhibits transfer of mycolic acids into cell wall of tubercle bacillus | Antituberculosis drug |
| isoniazid (3) | Prodrug, which once activated, inhibits synthesis of mycolic acids (essential component bacterial cell wall) | Antituberculosis drug |
| pyrazinamide (3) | Mechanism unclear. Metabolite (pyrazinoic acid) may lower intrabacterial pH to level that could inactivate vital target enzyme (e.g. fatty acid synthase. | Antituberculosis drug |
| rifampicin (3) | inhibits DNA-dependent RNA polymerase activity in bacillus | Antituberculosis drug |
| clotrimazole (2) | Azole, which inhibits lanosine 14α-demethylase, (responsible for converting lanosterol to ergosterol, main sterol in fungal cell membrane). This leads to increased membrane permeability and apparent disruption of enzyme systems bound to membrane | Antifungal medicine |
| nystatin (3) | Binds to sterols in cell membrane of susceptible species, resulting in increased membrane permeability and subsequent leakage of intracellular components. | Antifungal medicine |
| aciclovir (3) | As triphosphate, competitively inhibits viral DNA polymerase and competes with natural deoxyguanosine triphosphate for incorporation into viral DNA, thus acting as chain terminator | Anti-herpes medicine |
| acetylsalicylic acid (1) | Reduces pain and inflammation by irreversibly inactivating cyclooxygenase (COX) enzyme, thus suppressing the production of prostaglandins and thromboxanes | NSAID |
| propranolol (1) | Beta-adrenoceptor blocker, which acts as competitive antagonist of catecholamines for binding beta-1 receptors in the heart, bronchial walls and vascular smooth muscle. Lipophilic and without intrinsic sympathomimetic activity | Anti-migraine |
| azathioprine (2) | Antagonizes purine metabolism and may inhibit synthesis of DNA, RNA, and proteins. May also interfere with cellular metabolism and inhibit mitosis. | Immunosuppressive drug |
| ciclosporin (3) | Binds to cyclophillin to form complex that inhibits calcineurin, the enzyme that activates of transcription of interleukin 2. Also inhibits lymphokine production and interleukin release | Immunosuppressive drug |
| ferrous salt (3) | Essential element in synthesis of haemoglobin (as well as myoglobin, cytochromes and other enzymes). | Antianaemia drug |
| folic acid (3) | Critical cofactor in enzymatic reactions required for DNA synthesis. Acts as carbon donor in the conversion of deoxyuridine to deoxythymidine. | Antianaemia drug |
| hydroxocobalamin (3) | Analogue of vitamin B12, which is converted to cobalamin, cofactor for homocysteine-methionine methyltransferase, which transfers methyl group from methyltetrahydrofolate to homocysteine to make methionine and thus ensure normal activation of fola | Antianaemia drug |
| clopidogrel (3) | Prodrug, active metabolite of which prevents binding of adenosine diphosphate (ADP) to its platelet receptor, impairing the ADP-mediated activation of the glycoprotein GPIIb/IIIa complex | Anti-platelet drug |
| dipyridamole (3) | Inhibits both adenosine deaminase and phosphodiesterase, preventing degradation of cAMP, an inhibitor of platelet function. Elevation in cAMP blocks release of arachidonic acid from membrane phospholipids and reduces thromboxane A2 activity. | Anti-platelet drug |
| heparin sodium (2) | Unfractionated heparin (UFH) which interacts with antithrombin III to accelerate rate of neutralization of certain activated coagulation factors (particularly prothrombin and Xa). | Anti-coagulant |
| enoxaparin (2) | LMWH which increases action of antithrombin III on factor Xa but not its action on prothrombin, because the LMW heparin molecules are too small to bind to both enzyme and inhibitor,essential for inhibition of thrombin but not for that of factor Xa | Anti-coagulant |
| phytomenadione (2) | Essential cofactor for the gamma-carboxylase enzymes which catalyze the posttranslational gammacarboxylation of glutamic acid residues in inactive hepatic precursors of coagulation factors II, VII, IX and X | Anti-coagulant |
| protamine sulfate (2) | strongly basic protein that forms an inactive complex with heparin | Anti-coagulant |
| warfarin (1) | Inhibits vit K reductase, resulting in depletion of reduced form of vit K (vitamin KH2). As vit K is cofactor for the carboxylation of glutamate, this limits gamma-carboxylation and subsequent activation of vit K-dependent coagulation proteins. | Anti-coagulant |
| atenolol (1) | Beta-adrenoceptor blocker, which acts as competitive antagonist of sympathomimetic neurotransmitters such as catecholamines for binding at beta (1)-adrenergic receptors in the heart, but to a lesser extent at beta (2) receptors also | Anti-anginal, Anti-arrhythmic, Anti-hypertensive |
| Glycerl trinitrate (3) | Converted to NO --> activates enzyme guanylate cyclase--> synth of cGMP--> phosphorylations in smooth muscle cells ----> dephosphorylation of myosin light chain of the smooth muscle fibre ---> relaxation of vascular smooth muscle cells and vasodilation. | Anti-anginal |
| isosorbide mononitrate (3) | Converted to NO --> activates enzyme guanylate cyclase--> synth of cGMP--> phosphorylations in smooth muscle cells ----> dephosphorylation of myosin light chain of the smooth muscle fibre ---> relaxation of vascular smooth muscle cells and vasodilation. | Anti-anginal |
| nicorandil (3) | Combines KATP channel activation with NO donor activity, and is used in refractory angina | Anti-anginal |
| verapamil (1) | Inhibits influx of extracellular calcium across both myocardial and vascular smooth muscle cell membranes | Anti-anginal |
| adenosine (3-4) | Slows conduction time through A-V node, interrupting re-entry pathways through A-V node, and thus restoring normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT), including PSVT associated with WPW Syndrome | Anti-arrhythmic |
| amiodarone (3-4) | Prolongs myocardial cell-action potential (phase 3) duration and refractory period and acts as a noncompetitive alpha- and beta-adrenergic inhibitor. | Anti-arrhythmic |
| digoxin (1) | Inhibits Na-K-ATPase membrane pump -->more intracellular Na+ and Ca++ concs and thus more activation of contractile proteins. Also increases slope of phase 4 depolarization, shortens action potential duration, and decreases max diastolic potential. | Anti-arrhythmic, Heart-failure drug |
| lidocaine (1) | Stabilizes neuronal membrane by inhibiting the ionic fluxes required for initiation and conduction of impulses thereby effecting local anaesthetic action | Anti-arrhythmic |
| verapamil (1) | Inhibits influx of extracellular calcium across both myocardial and vascular smooth muscle cell membranes | Anti-arrhythmic |
| amlodipine (1) | Calcium channel blocking agent which decreases arterial smooth muscle contractility and subsequent vasoconstriction by inhibiting the influx of calcium ions through L-type calcium channels | Anti-hypertensive |
| losartan (3-4) | Competitive antagonist at angiotensin II AT1-receptor on vascular smooth muscle | Anti-hypertensive |
| doxazosin (3-4) | Inhibits postsynaptic alpha (1)-adrenoceptors on vascular smooth muscle. This inhibits vasoconstrictor effect of circulating and locally released catecholamines (epinephrine and norepinephrine), resulting in peripheral vasodilatation | Anti-hypertensive |
| ramipril (1) | Ramiprilat, active metabolite, competes with angiotensin I for binding at angiotensin-converting enzyme, blocking the conversion of angiotensin I to angiotensin II (class ACE inhibitor) | Anti-hypertensive, Heart-failure drug |
| bisoprolol (3-4) | Beta-adrenoceptor blocker, which acts as competitive antagonist of catecholamines for binding at beta 1 and slightly beta (2) receptors also. Lipophilic and exhibits no intrinsic sympathomimetic activity (ISA) or membrane stabilizing activity. | Heart-failure drug |
| furosemide (1) | Inhibits reabsorption of sodium and chloride in ascending limb of the loop of Henle, thus increasing urinary excretion of sodium, chloride, and water | Heart-failure drug, Diuretic, |
| bendroflumethiazide (1) | Inhibits active Cl reabsorption at distal tubule, increasing excretion Na, Cl & H2O. Also inhibits Na ion transport across renal tubular epithelium by binding to thiazide sensitive Na-Cl transporter so incr. K excretion via Na-K exchange mechanism. | Heart-failure drug, Diuretic |
| dopamine | Produces +ve chronotropic and inotropic effects, resulting in increased heart rate and cardiac contractility. This is accomplished directly by exerting an agonist action on beta-adrenoceptors and indirectly by causing release of norepinephrine. | Heart-failure drug |
| streptokinase (3) | Cleaves Arg/Val bond in plasminogen to form proteolytic enzyme plasmin. Plasmin in turn degrades fibrin matrix of thrombus, thereby exerting thrombolytic action (also rt-PA and tenecteplase) | Anti-thrombotic |
| simvastatin (1) | Hydrolysed to active metabolite which competes with HMG-CoA for HMG-CoA reductase, a hepatic microsomal enzyme, and thus reduces quantity of mevalonic acid, a precursor of cholesterol | Lipid-lowering drug |
| betamethasone (2) | Binds with high affinity to specific cytoplasmic receptors to produce inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, and suppression of humoral immune responses | Anti-inflammatory |
| tropicamide (3) | Muscarinic (M4) antagonist, which blocks responses of iris sphincter muscle to the iris and ciliary muscles to cholinergic stimulation, producing dilation of the pupil and paralysis of the ciliary muscle. | opthalmic medicine |
| ethanol (1) | Osmolyte or dehydrating agent that disrupts the osmotic balance across bacterial cell membranes. The sedative effects of ethanol in man are mediated through binding to GABA receptors and glycine receptors (alpha 1 and alpha 2 subunits) | antiseptic |
| amiloride (3) | Inhibits sodium reabsorption in the distal convoluted tubules and collecting ducts in the kidneys by binding to the amiloride-sensitive sodium channels. This promotes the loss of sodium and water from the body, but without depleting potassium | Diuretic |
| spironolactone (3) | specific antagonist of aldosterone, acting through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule ---> more Na+ and H20 excreted, while K+ is retained | Diuretic |
| aluminium hydroxide (1) | Reacts with excess acid in the stomach, reducing its acidity | Antacid |
| compound alginate preparations (3) | Alginate taken in combination with antacid increases viscosity of stomach contents and protects oesophageal mucosa from acid reflux. Some alginate containing preps form viscous gel that floats on surface of stomach contents, reducing symptoms of reflux. | Anti-ulcer drug |
| omeprazole (3) | Proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H + /K + -ATPase in the gastric parietal cell, blocking the final step in HCL production. (Lansoprazole is also widely used) | Antacid |
| ranitidine (2) | Competitive inhibitor of histamine at parietal cell H2 receptor. Suppresses normal secretion HCl. Other substances that promote acid secretion (such as gastrin and acetylcholine) also have reduced effect on parietal cells when H2 receptors are blocked. | Antacid |
| metoclopramide (3) | Dopamine antagonist which raises threshold of activity in the chemoreceptor trigger zone and decreases input from afferent visceral nerves. Also increases gastric emptying rate (domperidone similar) | Antiemetic |
| ondansetron (3) | Selective antagonist of serotonin (5-HT3) receptors located on nerve terminals of vagus in periphery and centrally in the chemoreceptor trigger zone of the area postrema | Antiemetic |
| prochlorperazine (3) | Antagonist of dopamine in chemoreceptor trigger zone. Also antagonist at cholinergic and alpha-adrenergic receptors | Antiemetic |
| promethazine (3) | Competes with free histamine for binding at H1-receptor sites everywhere. Relief of nausea appears to be related to central anticholinergic actions and may implicate activity on the medullary chemoreceptor trigger zone (cyclizine similar) | Antiemetic |
| mesalazine (3) | metabolized in the gut to 5-aminosalicylic acid an antioxidant that possibly traps free radicals, diminishing inflammation locally by blocking cyclooxygenase and inhibiting prostaglandin production in the colon. | GI anti-inflammatory |
| ispaghula husk (3) | Bulk-forming laxative. Polysaccharide polymer not broken down by the normal processes of digestion in upper GI tract. Form bulky hydrated mass in gut lumen promoting peristalsis and improving faecal consistency. | Laxative |
| lactulose (3) | Not absorbed from GI tract and increases amount of water in large bowel, by drawing fluid from body into bowel or by retaining fluid they were administered with. Produces osmotic diarrhoea of low pH, and discourages prolif of ammonia-producing organisms. | Laxative |
| senna (3) | Stimulant laxative which directly stimulates the myenteric plexus, resulting in increased peristalsis and thus defecation | Laxative |
| loperamide (3) | Non-selective calcium channel blocker that also binds to opioid mu-receptors in the myenteric plexus to reduce peristalsis. | Anti-diarrhoeal |
| gliclazide (2) | Binds to (SUR1) --> ATP sensitive K+ channels blocked-->decrease in K+ efflux -->depolarization of pancreatic beta cells -->voltage-dependent Ca++ channels in beta cell open -->calmodulin activation -->exocytosis of insulin containing secretory granules. | Anti-diabetic drug |
| insulin (1) | Binds to insulin receptor. The binding of insulin to the alpha subunit of IR stimulates the tyrosine kinase activity intrinsic to the beta subunit of the receptor. Different parenteral formulations have different pharmacokinetic profiles. | Insulin |
| metformin (2) | Decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. | Anti-diabetic drug |
| pioglitazone (2) | Reduces hepatic glucose output and increases glucose uptake, enhancing effectiveness of endogenous insulin and reducing amount of exogenous insulin needed to maintain given level of blood glucose. Sensitizes to insulin | Anti-diabetic drug |
| levothyroxine (1) | Converted to tri-iodothyronine (T3) which binds to nuclear receptor proteins and affects transcription and production of specific proteins | Thyroid hormone |
| Carbimazole (2) | decreases output thyroid hormones from gland, possibly by inhibiting iodination tyrosyl residues in thyroglobulin via inhibition of thyroperoxidase H2O2 complex | Anti-thyroid drug |
| vecuronium (1) | Non-depolarising neuromuscular blocker: Competitive antagonist at nicotinic cholinergic receptors at neuromuscular junction, preventing acetylcholine- induced depolarisation, and thus calcium ion release and muscle contraction. | Muscle relaxant |
| neostigmine (1) | Inhibits acetylcholinesterase in synaptic cleft by competing with ACh for attachment to acetylcholinesterase -->slows down hydrolysis of ACh -->increases efficiency of cholinergic transmission in the neuromuscular junction and prolonging effects of ACh | Cholinesterase inhibitor |
| suxamethonium (3) | Depolarising neuromuscular blocker: acts by mimicking ACh at neuromuscular junction but hydrolysis prolonged, resulting in neuromuscular blockade. Unlike non-depolarising neuromuscular blocking drugs, action cannot be reversed and recovery is spontaneous | Muscle relaxant |
| pyridostigmine (1) | Inhibits AChesterase in synaptic cleft by competing with ACh for attachment to AChesterase -->slows down hydrolysis of ACh -->increases efficiency of cholinergic transmission in the neuromuscular junction and prolonging effects of ACh. Long acting. | Cholinesterase inhibitor |
| aciclovir (3) | As triphosphate, competitively inhibits viral DNA polymerase and competes with natural deoxyguanosine triphosphate for incorporation into viral DNA, thus acting as chain terminator | Opthalmic anti-infective agent |
| latanoprost (3) | Prostaglandin F2 alpha analogue and prostanoid selective FP receptor agonist that is believed to reduce intraocular pressure (IOP) by increasing outflow of aqueous humor. | Glaucoma drug |
| pilocarpine (2) | Cholinergic (muscarinic) agonist which produces contraction of iris sphincter muscle and ciliary muscle (when given topically to the eyes) | Miopic drug |
| timolol (1) | Mode of action unknown but appears to reduce aqueous humor production | Glaucoma drug |
| methadone (2) | Opioid which acts as agonist, predominantly at the µ- opioid receptor. | Opioid mimicker |
| beclometasone (2) | Binds with high affinity to specific cytoplasmic receptors to produce inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, and suppression of humoral immune responses | Bronchodilator for asthma |
| ipratropium bromide (3) | Blocks muscarinic cholinergic receptors, without specificity for subtypes, resulting in decrease in formation of cyclic guanosine monophosphate (cGMP). This results in effect on intracellular Ca++, and decreased contractility of smooth muscle | Anticholinergic drug used in COPD |
| salbutamol (1) | Competitive β2-adrenergic agonist causing relaxation of bronchial smooth muscle (salmeterol is longer acting agent used in specialised circumstances) | Bronchodilator used in asthma and COPD |
| ascorbic acid (3) | Reducing agent required for collagen formation, synthesis of the biogenic sympathetic amines, norepinephrine and epinephrine, and synthesis of carnitine. | Vit C |
| nicotinamide (B3) (3) | Precursor to nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP), vital cofactors for many essential enzymes. | Vit B3 |
| pyridoxine (B6) (3) | metabolism of amino acids and glycogen, synthesis of nucleic acids, haemoglobin, sphingomyelin and othersphingolipids, and synthesis of the neurotransmitters serotonin, dopamine, norepinephrine and gammaaminobutyric acid (GABA). | Vit B6 |
| thiamine (B1) (3) | Co-enzyme in several vital metabolic processes, including oxidative decarboxylation of pyruvate to acetyl CoA via pyruvate dehydrogenase. | Vit B1 |
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