Drug name | Class | Action | Side effects |
tacrine | AchE inhibitor | treats alzheimers | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give atropine |
echothiophate | AchE inhibitor. organophosphate - irreversible | treats glaucoma | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give pralidoxime (2-PAM) to cure & atropine to help |
isoflurophate | AchE inhibitor. organophosphate - irreversible | treats glaucoma | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give pralidoxime (2-PAM) to cure & atropine to help |
malathion | AchE inhibitor. organophosphate - irreversible | insecticide | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give pralidoxime (2-PAM) to cure & atropine to help |
parathion | AchE inhibitor. organophosphate - irreversible | insecticide | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give pralidoxime (2-PAM) to cure & atropine to help |
sarin | AchE inhibitor. organophosphate - irreversible | nerve gas in war | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give pralidoxime (2-PAM) to cure & atropine to help |
physostigmine | AchE inhibitor. carbamate - reversible | treats glaucoma and bowel atony. Antidote for OD on atropine, phenothiazine, & TCAs. | cataracts & too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give pralidoxime (2-PAM) to cure & atropine to help |
neostigmine | AchE inhibitor. carbamate - reversible | treats ileus, pee retention, & myasthenia gravis. Reverses nondepolarizing Nm blockers (ex: tubocurarine) | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give pralidoxime (2-PAM) to cure & atropine to help |
pyridostigmine | AchE inhibitor. carbamate - reversible | treats ileus, pee retention, & myasthenia gravis. Reverses nondepolarizing Nm blockers (ex: tubocurarine) | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give pralidoxime (2-PAM) to cure & atropine to help |
acetylcholine | Muscarinic agonist | M & N receptors. No clinical use since broken down in blood. | leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give atropine |
carbachol | Muscarinic agonist | treats glaucoma. Used to cause miosis during eye surgery. | leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give atropine |
bethanechol | Muscarinic agonist | treats ileus & pee retention | leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give atropine |
methacholine | Muscarinic agonist | asthma challenge test. Will cause bronchoconstriction | leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give atropine |
pilocarpine | Muscarinic agonist | treats glaucoma topically or xerostomia (dry mouth) | can cross BBB -> hallucinate & seizure. leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give atropine |
atropine | Muscarinic blocker - reversible nonselective | belladona plant. treats brady, GI spasms/diarrhea, excessive secretion, cystitis, and toxic levels of Ach/mushroom poisoning | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. If OD give physostigmine |
scopolamine | Muscarinic blocker - nonselective | belladona plant. Treats motion sickness. | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. If OD give physostigmine |
tropicamide | Muscarinic blocker | topical used in ophthalmology to dilate eye | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. |
ipratropium | Muscarinic blocker | inhale to treat asthma/COPD | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. If OD give physostigmine |
benztropine | Muscarinic blocker | treats parkinsons and symptoms from antipsychotics | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. If OD give physostigmine |
trihexyphenidyl | Muscarinic blocker | treats parkinsons and symptoms of antipsychotics | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. If OD give physostigmine |
meperidine | Muscarinic blocker | | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. If OD give physostigmine |
amantadine | Muscarinic blocker | | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. If OD give physostigmine |
quinidine | Muscarinic blocker | | dry as a bone, blind as a bat (mydriasis+cycloplegia), red as a beet (tachy+hypertherm+vasodil), mad as a hatter, sedation, pee+poo retention. Will cause acute crisis in narrow angle glaucoma. If OD give physostigmine |
succinylcholine | Neuromuscular blocker/skel M relaxer (nicotinic Nm receptor) | opens Na channels depolarizing the membrane - fasciculations then flaccid paralysis. Used with anesthesia IV. | bronchoconstriction, dec bp, resp paralysis, all reversible w/ AchE inhibitors. Beware mutations in Ryr or pseudocholinesterase leading to hyperkalemia & malignant hyperthermia. (Treat with dantrolene to block Ca from leaving SR). |
tubocurarine | Neuromuscular blocker/skel M relaxer (nicotinic Nm receptor) | competes w/ Ach but does not depolarize the M. Used with anesthesia IV - 1st eyes & face, last resp Ms. | bronchoconstriction, dec bp, reversed by AchE inhibitors. Beware mutations in Ryr or pseudocholinesterase leading to hyperkalemia & malignant hyperthermia. (Treat with dantrolene to block Ca from leaving SR). |
pancuronium | Neuromuscular blocker/skel M relaxer (nicotinic Nm receptor) | competes w/ Ach but does not depolarize the M. Used with anesthesia IV - 1st eyes & face, last resp Ms. Longer than tubocurarine. | bronchoconstriction, dec bp, reversed by AchE inhibitors. Beware mutations in Ryr or pseudocholinesterase leading to hyperkalemia & malignant hyperthermia. (Treat with dantrolene to block Ca from leaving SR). |
atracurium | Neuromuscular blocker/skel M relaxer (nicotinic Nm receptor) | competes w/ Ach but does not depolarize the M. Used with anesthesia IV - 1st eyes & face, last resp Ms. | converted to laudanosine which can cause seizures. Bronchoconstriction, dec bp |
mivacurium | Neuromuscular blocker/skel M relaxer (nicotinic Nm receptor) | competes w/ Ach but does not depolarize the M. Used with anesthesia IV - 1st eyes & face, last resp Ms. | Bronchoconstriction, dec bp |
nicotine | Nicotinic blocker | competes with Ach. 1st stimulates then blocks by persistent depolarization. Treats HTN emergency | block dominant ANS = tachy, vasodil, mydriasis+cycloplegia, pee+poo retention, xerostomia, anhydrosis |
hexamethonium | Nicotinic blocker | competes with Ach. Treats HTN emergency | block dominant ANS = tachy, vasodil, mydriasis+cycloplegia, pee+poo retention, xerostomia, anhydrosis |
mecamylamine | Nicotinic blocker | competes with Ach. Treats HTN emergency | block dominant ANS = tachy, vasodil, mydriasis+cycloplegia, pee+poo retention, xerostomia, anhydrosis |
trimethaphan | Nicotinic blocker | competes with Ach. Treats HTN emergency | block dominant ANS = tachy, vasodil, mydriasis+cycloplegia, pee+poo retention, xerostomia, anhydrosis |
phenylephriene | α 1 agonist | vasoconstricts so inc bp & reflex brady. Treats nasal congestion, hypotension, paroxysmal atrial tachy (via vagal reflex), & used in eye exam to cause mydriasis w/out cycloplegia | rebound mucosal swelling & HTN headache |
methoxamine | α 1 agonist | vasoconstricts so inc bp & reflex brady. Treats hypotension & paroxysmal atrial tachy (via vagal reflex) | HTN headache |
clonidine | α 2 agonist | dec symp. Treats mild/mod HTN (wont affect kidney) & can help w/ w/drawal from benzos & opiates | sedation, orthostatic hypotension, sex dysfunc |
methyldopa | α 2 agonist | dec symp. Treats mild/mod HTN (wont affect kidney) & can help w/ w/drawal from benzos & opiates | sedation, orthostatic hypotension, sex dysfunc |
dobutamine | β agonist (β 1 >>> β 2) | inc HR. IV Treats CHF (forces heart to pump enough) | arrhythmias, angina, headache, HTN |
isoproterenol | β agonist (β 1 = β 2) | IV Treats AV node block, brady, & bronchospasm | arrhythmias, angina, headache, flush |
albuterol | β 2 agonist | inhaled - rapidly treats asthma/COPD | skel M tremors, hyperglycemia, arrhythmias, headache |
salmeterol | β 2 agonist | inhaled - treats asthma/COPD but takes longer than albuterol | skel M tremors, hyperglycemia, arrhythmias, headache |
terbutaline | β 2 agonist | IV/oral - treats asthma/COPD but takes longer than albuterol. Also treats preterm labor | skel M tremors, hyperglycemia, arrhythmias, headache |
ritodrine | β 2 agonist | treats preterm labor | skel M tremors, hyperglycemia, arrhythmias, headache |
epinephrine | agonist for: α 1 = α 2, β 1 = β 2, but β 2 > α 1 so low dose epi is β 2 only but high dose epi is β 2 & α 1 | Treats anaphylaxis by vasoconstricting & bronchodilating (could also help asthma attack). Helps local anesthetics/counters hemorrhage. Can't do orally due to rapid breakdown by COMT. Doesn't cross BBB | arrhythmias, HTN, headache, skel M tremor, pulmonary edema |
norepinephrine | agonist for: α 1 = α 2, β 1 >>>>> β 2 | vasoconstriction, reflex brady, & inc heart contraction. Helps local anesthetics/counters hemorrhage. Last resort in shock. Can't do orally due to rapid breakdown by COMT. Doesn't cross BBB | arrhythmias, dec perfusion of kidneys & tissues |
dopamine | D1 & D2 agonist at low dose (in renal bv), β1 & β2 at mid dose, α 1 at high dose | Treats acute renal failure by inc blood flow, treats shock & CHF by inc HR. Can't do orally due to rapid breakdown by COMT. Doesn't cross BBB | arrhythmias, tachy, HTN & dec renal perfusion at high dose |
tyramine | indirect adrenergic receptor agonist | in red wine, beer, cheese, & chocolate. Incs norepi. Broken down by MAO. | If on MAO inhibitor beware HTN emergency |
methylphenidate | amphetamine - indirect adrenergic receptor agonist | can cross BBB, releases stores of norepi & dopamine, & inc 5HT. Treats ADHD, narcolepsy, also vasoconstricts so inc bp. | psych and physical dependance, psychosis, confusion, insomnia, restless, tachy, arrhythmias, headache. Don't use w/ MAO inhibitor -> HTN emergency. If OD use chlorpromazine to block α helping HTN & CNS. |
methamphetamine | amphetamine - indirect adrenergic receptor agonist | can cross BBB, releases stores of norepi & dopamine, & inc 5HT. Treats ADHD, narcolepsy, also vasoconstricts so inc bp. | psych and physical dependance, psychosis, confusion, insomnia, restless, tachy, arrhythmias, headache. Don't use w/ MAO inhibitor -> HTN emergency. If OD use chlorpromazine to block α helping HTN & CNS. |
dextroamphetamine | amphetamine - indirect adrenergic receptor agonist | can cross BBB, releases stores of norepi & dopamine, & inc 5HT. Treats ADHD, narcolepsy, also vasoconstricts so inc bp. | psych and physical dependance, psychosis, confusion, insomnia, restless, tachy, arrhythmias, headache. Don't use w/ MAO inhibitor -> HTN emergency. If OD use chlorpromazine to block α helping HTN & CNS. |
ephedrine | indirect adrenergic receptor agonist | releases stores of norepi, also direct agonist for α and β, vasoconstricts, treats nasal congestion, bronchospasm, hypotension | tachy, HTN, arrhythmias, insomnia, anxiety (β1 in CNS) |
cocaine | indirect adrenergic receptor agonist | | |
tricyclic antidepressants | indirect adrenergic receptor agonist | | |
prazosin | α 1 blocker | dec bp by dec peripheral resistance. Treats HTN & BPH | reflex tachy, Na/H2O retention, dizzy, orthostatic hypotension, weak, headache, ejaculation probs, GI hypermotility |
doxazosin | α 1 blocker | dec bp by dec peripheral resistance. Treats HTN & BPH | reflex tachy, Na/H2O retention, dizzy, orthostatic hypotension, weak, headache, ejaculation probs, GI hypermotility |
terazosin | α 1 blocker | dec bp by dec peripheral resistance. Treats HTN & BPH | reflex tachy, Na/H2O retention, dizzy, orthostatic hypotension, weak, headache, ejaculation probs, GI hypermotility |
tamsulosin | α 1 blocker | BPH only (specific for its subset of α 1 receptors) | orthostatic hypotension, ejaculation probs |
mirtazapine | α 2 blocker (also inc 5HT & norepi release) | treats depression & anorexia | sedation, weight gain, inc blood cholesterol levels |
yohimbine | α 2 blocker | treats orthostatic hypotension & erectile dysfunc | |
phentolamine | nonselective α blocker | treats HTN due to pheochromocytoma short-term | reflex tachy, orthostatic hypotension, GI hypermotility |
phenoxybenzamine | nonselective α blocker (IRREVERSIBLE) | treats HTN due to pheochromocytoma or spinal cord injury, BPH, & Raynaud's | reflex tachy, orthostatic hypotension, ejaculation probs |
acebutolol | β 1 blocker | Treats HTN, MI, CHF, arrhythmias, ischemia, migraine, esophageal variceal bleeding (because dec HR, CO, stroke vol, renin release), open angle glaucoma (dec tear production), essential tremor, & helps w/ thyroid storms & pheochromocytoma (w/ an α blocker) | AV node block, brady, HF, hypotension, exercise intolerance, vasoconstrict, rebound HTN/tachy/angina (due to up regulation), bronchoconstrict, hypoglycemia in diabetics, insomnia, nightmares, depression |
atenolol | β 1 blocker | Treats HTN, MI, CHF, arrhythmias, ischemia, migraine, esophageal variceal bleeding (because dec HR, CO, stroke vol, renin release), open angle glaucoma (dec tear production), essential tremor, & helps w/ thyroid storms & pheochromocytoma (w/ an α blocker) | AV node block, brady, HF, hypotension, exercise intolerance, vasoconstrict, rebound HTN/tachy/angina (due to up regulation), bronchoconstrict, hypoglycemia in diabetics, insomnia, nightmares, depression |
metoprolol | β 1 blocker | Treats HTN, MI, CHF, arrhythmias, ischemia, migraine, esophageal variceal bleeding (because dec HR, CO, stroke vol, renin release), open angle glaucoma (dec tear production), essential tremor, & helps w/ thyroid storms & pheochromocytoma (w/ an α blocker) | AV node block, brady, HF, hypotension, exercise intolerance, vasoconstrict, rebound HTN/tachy/angina (due to up regulation), bronchoconstrict, hypoglycemia in diabetics, insomnia, nightmares, depression |
esmolol | β 1 blocker - IV short acting | Treats HTN, MI, CHF, arrhythmias, ischemia, migraine, esophageal variceal bleeding (because dec HR, CO, stroke vol, renin release), open angle glaucoma (dec tear production), essential tremor, & helps w/ thyroid storms & pheochromocytoma (w/ an α blocker) | AV node block, brady, HF, hypotension, exercise intolerance, vasoconstrict, rebound HTN/tachy/angina (due to up regulation), bronchoconstrict, hypoglycemia in diabetics, insomnia, nightmares, depression |
propranolol | nonselective β blocker | treats migraine, HTN, arrhythmia, tachy, performance anxiety, essential tremor, & thyroid storm because it causes bronchoconstrict, vasoconstrict, dec bp, CO, HR, blocks glycogenolysis/gluconeogenesis, & inc LDL/TG (dec HDL) | think it out |
timolol | nonselective β blocker | treats glaucoma by dec aqueous humor, migraine, HTN, arrhythmia, tachy, performance anxiety, essential tremor, & thyroid storm because it causes bronchoconstrict, vasoconstrict, dec bp, CO, HR, blocks glycogenolysis/gluconeogenesis, & inc LDL/TG (dec HDL) | think it out |
pindolol | nonselective β blocker | | |
nadolol | nonselective β blocker | | |
note for all β blockers | names: β 1 selective = levobet B.E.A.M. | treats angina, HTN, post-MI, & arrhythmias | if OD use glucagon to inc HR via receptors G-protein linked to adenylyl cyclase. Beware rebound if stop drug due to up-regulation & beware lack of warning signs in hypoglycemia |
sotalol | K channel + β blocker | treats arrhythmias | look up later |
labetolol | α 1 + β blocker | treats CHF, HTN, A. fib | orthostatic hypotension, dizzy, don't use in acute CHF or when not hemodynamically stable |
carvedilol | α 1 + β blocker | treats CHF, HTN | orthostatic hypotension, dizzy, don't use in acute CHF or when not hemodynamically stable |
haloperidol | #1 typical antipsychotic/neuroleptic | Most potent - blocks dopamine receptors so deal w/ + symptoms in schizophrenia & psychosis. Also treats Tourette's & Huntington's. If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms | inc risk extrapyramidal SE (akinesia, tremors, akathisia, TARDIVE DYSKINESIA) but less anticholinergic SE (dry as a bone, blind as a bat, red as a beet, mad as a hatter). Also causes inc prolactin (so sex dysfunc), inc weight, sedation, dizzy & temp probs |
thiothixene | typical antipsychotic/neuroleptic | More potent - blocks dopamine receptors so deal w/ + symptoms in schizophrenia & psychosis. If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms | inc risk extrapyramidal SE (akinesia, tremors, akathisia, TARDIVE DYSKINESIA) but less anticholinergic SE (dry as a bone, blind as a bat, red as a beet, mad as a hatter). Also causes inc prolactin (so sex dysfunc), inc weight, sedation, dizzy & temp probs |
fluphenazine | typical antipsychotic/neuroleptic | More potent - blocks dopamine receptors so deal w/ + symptoms in schizophrenia & psychosis & mania. Injection so dec freq of dosing or noncompliant. If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms | inc risk extrapyramidal SE (akinesia, tremors, akathisia, TARDIVE DYSKINESIA) but less anticholinergic SE (dry as a bone, blind as a bat, red as a beet, mad as a hatter). Also causes inc prolactin (so sex dysfunc), inc weight, sedation, dizzy & temp probs |
thioridazine | typical antipsychotic/neuroleptic | Less potent - blocks dopamine receptors so deal w/ + symptoms in schizophrenia & psychosis. If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms | inc risk anticholinergic SE (dry as a bone, blind as a bat, red as a beet, mad as a hatter) but less extrapyramidal SE (akinesia, tremors, akathisia, TARDIVE DYSKINESIA). Also causes inc prolactin (so sex dysfunc), inc weight, sedation, dizzy & temp probs |
chlorpromazine | typical antipsychotic/neuroleptic | Less potent - blocks dopamine receptors so deal w/ + symptoms in schizophrenia & psychosis. If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms | inc risk anticholinergic SE (dry as a bone, blind as a bat, red as a beet, mad as a hatter) but less extrapyramidal SE (akinesia, tremors, akathisia, TARDIVE DYSKINESIA). Also causes inc prolactin (so sex dysfunc), inc weight, sedation, dizzy & temp probs |
loxapine | typical antipsychotic/neuroleptic | Last resort - blocks dopamine receptors so deal w/ + symptoms in schizophrenia & psychosis. If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms | inc risk extrapyramidal SE (akinesia, tremors, akathisia, TARDIVE DYSKINESIA) but less anticholinergic SE (dry as a bone, blind as a bat, red as a beet, mad as a hatter). Also causes inc prolactin (so sex dysfunc), inc weight, sedation, dizzy & temp probs |
olanzapine | #1 atypical antipsychotic/neuroleptic | blocks dopamine & serotonin receptors so deal w/ + & - symptoms in schizophrenia & psychosis. | may develop diabetes but less SE than typicals (extrapyramidal, anticholinergic, sex dysfunc, inc weight, sedation, dizzy & temp probs) |
clozapine | atypical antipsychotic/neuroleptic | blocks dopamine & serotonin receptors so deal w/ + & - symptoms in schizophrenia & psychosis. | seizures and agranulocytosis (so do weekly blood tests or could die) - so reserved for folks the other drugs don't help. less SE than typicals (extrapyramidal, anticholinergic, sex dysfunc, inc weight, sedation, dizzy & temp probs) |
risperidone | atypical antipsychotic/neuroleptic | blocks dopamine & serotonin receptors so deal w/ + & - symptoms in schizophrenia & psychosis. | maybe stroke in elderly but less SE than typicals (extrapyramidal, anticholinergic, sex dysfunc, inc weight, sedation, dizzy & temp probs). If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms |
aripiprazole | atypical antipsychotic/neuroleptic | blocks dopamine & serotonin receptors (partial agonist for some 5HT) so deal w/ + & - symptoms in schizophrenia & psychosis & mania & depression. | less SE than typicals (extrapyramidal, anticholinergic, sex dysfunc, inc weight, sedation, dizzy & temp probs). If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms |
quetiapine | atypical antipsychotic/neuroleptic | blocks dopamine & serotonin receptors so deal w/ + & - symptoms in schizophrenia & psychosis & mania. | less SE than typicals (extrapyramidal, anticholinergic, sex dysfunc, inc weight, sedation, dizzy & temp probs). If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms |
ziprasidone | atypical antipsychotic/neuroleptic | blocks dopamine & serotonin receptors so deal w/ + & - symptoms in schizophrenia & psychosis & mania. IM for acute cases. | could die if elderly but less SE than typicals (extrapyramidal, anticholinergic, sex dysfunc, inc weight, sedation, dizzy & temp probs). If OD use benztropine/trihexyphenidyl or diphenhydramine or dantrolene depending on symptoms |
phenelzine | MAO inhibitor | inc norepi, epi, & serotonin. Treats resistant/atypical depression & anxiety, hypochondriasis | beware tyramine in food, TCAs, levodopa, α and β agonists causing too much stimulation. HTN crisis: HTN, arrhythmia, hypertherm. TCAs, SSRIs, meperidine can cause serotonin syndrome. If OD use phentolamine to block αs or chlorpromazine (antipsychotic) |
tranylcypromine | MAO inhibitor | inc norepi, epi, & serotonin. Treats resistant/atypical depression & anxiety, hypochondriasis | beware tyramine in food, TCAs, levodopa, α and β agonists causing too much stimulation. HTN crisis: HTN, arrhythmia, hypertherm. TCAs, SSRIs, meperidine can cause serotonin syndrome. If OD use phentolamine to block αs or chlorpromazine (antipsychotic) |
serotonin syndrome -- neuroleptic malignant syndrome | because of MAO inhibitors, SSRIs, tyramine -- because of haloperidol, fluphenazine, thiothixene or other anitpsychotics | overstimulation | myoclonus/rigid, hypertherm, tremor/seizures, ANS instability/CV collapse. If emergency give cyproheptadine & will clear sys of the drug |
amitriptyline | TCA | blocks serotonin & norepi reuptake. Treats depression, PTSD, phobia/anxiety & neuropathic pain | M & α blocked. fat soluble. Avoid MAO inhibitors. OD = coma, convulsions, arrhythmias. |
imipramine | TCA | blocks serotonin & norepi reuptake. Treats depression, PTSD, phobia/anxiety, panic attacks, & enuresis (bed wetting) | M & α blocked. fat soluble. Avoid MAO inhibitors. OD = coma, convulsions, arrhythmias. |
clomipramine | TCA | blocks serotonin & norepi reuptake. Treats depression, PTSD, phobia/anxiety & OCD | M & α blocked. fat soluble. Avoid MAO inhibitors. OD = coma, convulsions, arrhythmias. |
doxepin | TCA | blocks serotonin & norepi reuptake. Treats depression, PTSD, phobia/anxiety | M & α blocked. fat soluble. Avoid MAO inhibitors. OD = coma, convulsions, arrhythmias. |
nortriptyline | TCA | blocks serotonin & norepi reuptake. Treats depression, PTSD, phobia/anxiety | M & α blocked. fat soluble. Avoid MAO inhibitors. OD = coma, convulsions, arrhythmias. |
amoxapine | TCA | blocks serotonin & norepi reuptake. Treats depression, PTSD, phobia/anxiety | M & α blocked. fat soluble. Avoid MAO inhibitors. OD = coma, convulsions, arrhythmias. |
desipramine | TCA | blocks serotonin & norepi reuptake. Treats depression, PTSD, phobia/anxiety | M & α blocked. fat soluble. Avoid MAO inhibitors. OD = coma, convulsions, arrhythmias. |
fluoxetine | SSRI | blocks serotonin reuptake. #1 for depression, PTSD, & OCD. Also used for bulimia, anxiety, & PMS. | anorgasmia, ANXIETY, weight loss, bruxism, inhibits P450. OD = serotonin syndrome. |
paroxetine | SSRI | blocks serotonin reuptake. #1 for depression, PTSD, & OCD. Also used for bulimia, anxiety, & PMS. | anorgasmia, anxiety, weight loss, bruxism, SEDATION, inhibits P450. OD = serotonin syndrome. |
sertraline | SSRI | blocks serotonin reuptake. #1 for depression, PTSD, & OCD. Also used for bulimia, anxiety, & PMS. | anorgasmia, anxiety, weight loss, bruxism, inhibits P450. OD = serotonin syndrome. |
fluvoxamine | SSRI | blocks serotonin reuptake. #1 for depression, PTSD, & OCD. Also used for bulimia, anxiety, & PMS. | anorgasmia, anxiety, weight loss, bruxism, inhibits P450. OD = serotonin syndrome. |
citalopram | SSRI | blocks serotonin reuptake. #1 for depression, PTSD, & OCD. Also used for bulimia, anxiety, & PMS. | anorgasmia, anxiety, weight loss, bruxism, inhibits P450. OD = serotonin syndrome. |
escitalopram | SSRI | blocks serotonin reuptake. #1 for depression, PTSD, & OCD. Also used for bulimia, anxiety, & PMS. | anorgasmia, anxiety, weight loss, bruxism, inhibits P450. OD = serotonin syndrome. |
buproprion | dopamine & norepi reuptake inhibitor | used for depression & smoking cessation | seizure |
trazodone | blocks serotonin reuptake | used for depression & insomnia | arrhythmias & priapism (painful long erection) |
venlafaxine | SNRI | blocks serotonin & norepi reuptake. Treats depression & anxiety | inc bp |
duloxetine | SNRI | blocks serotonin & norepi reuptake. Treats depression & diabetic peripheral neuropathy | inc bp |
atomoxetine | selective norepi reuptake inhibitor | treats ADHD | M & α blocked. fat soluble. Avoid MAO inhibitors. OD = coma, convulsions, arrhythmias. |
lithium | dec inositol phosphate (PIP2/IP3) | treats bipolar disorder. Also migraines & chronic aggression | very low TI & teratogen (malform of tricuspid valve). Edema (so beware in HF), acne, hypothyroid, tremor, "flu", deadly seizures, coma, hard on kidneys (thiazides & loops will inc tox) nephrogenic diabetes insipidus (dec ADH receptors. fix w/ amiloride) |
valproic acid | anticonvulsant | treats mania, rapid cycling bipolar, & impulse ctrl issues by inc GABA | regular blood work to monitor liver tox & agranulocytosis. Teratogen (neural tube defects), coma, & cardiac arrest |
carbamazepine | anticonvulsant | treats mania, rapid cycling bipolar, & impulse ctrl issues by inc GABA | regular blood work to monitor liver tox & agranulocytosis. Rash is first warning sign of tox. Teratogen (cleft lip/palate), coma, & cardiac arrest. |
gabapentin | anticonvulsant | GABA analog. treats mania/bipolar if preg | later |
phenytoin | anticonvulsant | | l |
ethosuximide | anticonvulsant | | l |
lamotrigine | anticonvulsant | | l |
felbamate | anticonvulsant | | l |
topiramate | anticonvulsant | | l |
vigabatrin | anticonvulsant | | l |
phenobarbital | sedative/hypnotic - barbiturate & anticonvulsant | inc Cl influx DURATION through GABA to hyperpolarize cell. Treats preg woman w/ seizures | induce P450 so inc metabolism of fat soluble drugs ex:OCP. Porphyrias, sedation, anesthesia, resp depression, coma, die. Long term=tolerance, psych+phys dependance. Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
thiopental | sedative/hypnotic - barbiturate | inc Cl influx DURATION through GABA to hyperpolarize cell. Used to induce anesthesia | induce P450 so inc metabolism of fat soluble drugs ex:OCP. Porphyrias, sedation, anesthesia, resp depression, coma, die. Long term=tolerance, psych+phys dependance. Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
clonazepam | sedative/hypnotic - benzodiazepine | inc Cl influx FREQUENCY through GABA to hyperpolarize cell. Treats mania/bipolar if preg & panic attacks/anxiety. Metabolized by liver to an active compound. | sedation & anesthesia then plateaus. Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
diazepam | sedative/hypnotic - benzodiazepine & anticonvulsant | | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
lorazepam | sedative/hypnotic - benzodiazepine & anticonvulsant | | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
alprazolam | sedative/hypnotic - benzodiazepine | | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
midazolam | sedative/hypnotic - benzodiazepine | | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
oxazepam | sedative/hypnotic - benzodiazepine | | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
temazepam | sedative/hypnotic - benzodiazepine | | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
flurazepam | sedative/hypnotic - benzodiazepine | | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
triazolam | sedative/hypnotic - benzodiazepine | | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. |
zaleplon | sedative/hypnotic | bzd agonist. Treats sleep disorders. | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. But less abuse & tolerance. |
zolpidem | sedative/hypnotic | bzd agonist. Treats sleep disorders. | Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. But less abuse & tolerance. |
buspirone | sedative/hypnotic | no effect on GABA. serotonin partial agonist. Used for general anxiety (not sedating) | no w/drawl or cross reactivity or abuse potential |
ethanol | sedative/hypnotic - Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. | aka alcohol. activates GABA complex. sedation, anesthesia, resp depression, coma & dec HR (>300mg/dL), (400mg/dL)death. inc risk GI cancer/bleed, boobs/small balls (liver not breaking estrogen), HTN, fetal al synd. Treats OD of methanol or ethylene glycol | alcohol dehydrogenase (zero order. needs NAD) ->acetaldehyde (NV headache) ->acetaldehyde dehydrogenase ->acetic acid (metabolic acidosis). Thiamine def=WernickeKorsakoff: ataxia, confused, ophthalmoplegia (EOM no move). Hepatitis, cirrhosis, pancreatitis |
ethylene glycol | sedative/hypnotic - Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. | auto antifreeze. activates GABA complex. sedation, anesthesia, resp depression, coma & dec HR, death. | alcohol dehydrogenase (zero order. needs NAD) ->glycoaldehyde ->acetaldehyde dehydrogenase ->oxalic acid crystals damage kidneys & metabolic acidosis |
methanol | sedative/hypnotic - Cross tolerant w/ alcohols, bzds, barbs & other sedative/hypnotic drugs. | antifreeze/fuel. activates GABA complex. sedation, anesthesia, resp depression, coma & dec HR, death. | alcohol dehydrogenase (zero order. needs NAD) ->formaldehyde ->acetaldehyde dehydrogenase ->formic acid (metabolic acidosis) & blindness |
cyproheptadine | cure | treats OD on antidepressant that caused serotonin syndrome | wipes sys clean of the antidepressant you took the time to build up to have an effect. Start from scratch |
dantrolene | cure | treats malignant hyperthermia caused by Neuromuscular blocker/skel M relaxer (nicotinic Nm receptor) | |
flumazenil | BZD blocker | treats OD of benzodiazepines | |
fomepizole | inhibits alcohol dehydrogenase | so acetaldehyde/formaldehyde don't form so don't get tox. Use in methanol & ethylene glycol poisoning | |
disulfram | inhibits acetaldehyde dehydrogenase | so acetaldehyde builds up when ingest ethanol so you get sick. Helps in quitting alcohol. | other drugs that act like this: metronidazole, cephalosporins, procarbazine (anticancer) |
chlordiazepoxide | sedative/hypnotic - benzodiazepine | used for alcohol detox | |
edrophonium | AchE inhibitor. reversible | treats myasthenia gravis. Use to differentiate btw MG & cholinergic crisis (wont get better). | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give atropine |
donepezil | AchE inhibitor | treats alzheimers | too much Ach = leaking from everywhere, miosis, brady, dec bp, skel M excitation then paralysis, broncho constriction. If OD give atropine |