Pharmacology for the PT
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| Acetaminophen | Analgesic & antipyretic; NOT anti-inflammatory | inhibits prostaglandins in CNS only | gastroc irritation, renal and hepatic toxicity
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| Glucocorticosteroids | Anti-inflammatory (systemic and in airways) | inhibit prostaglandins | catabolic effects, adrenocortical shock
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| Diuretics | HTN and Congestive Heart Failure | increase excretion of water | depletion of electrolytes, orthostatic hypotension, weakness/fatigue
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| Beta-Blockers (-olol) | HTN, arrhythmia, angina, heart failure, MI (decrease HR and force of contraction) | Block effects of epinephrine & norepinephrine (adrenergic blocker) | Bronchoconstriction, orthostatic hypotension, decrease exercise capacity
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| Vasodilators | HTN & Heart failure | cause vasodilation of vascular structures | Postural hypotension, reflex tachycardia, dizziness, edema/fluid retention
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| ACE inhibitors (-pril) | HTN & Heart failure | decrease formation of AngII (which causes vasoconstriction), therefore causing vasodilation | dry cough, dizziness, allergic reaction
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| Calcium Channel Blockers (-ipine) | HTN, angina, arrythmia | limit calcium entry into muscle; promote vasodilation | peripheral edema, altered HR, orthostatic hypotension, risk of MI
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| Heparin | Anticoagulant | increase effects of antithrombin II | Hemorrhage
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| Warfarin | Anticoagulant | inhibit vitamin K (which synthesizes klotting factors) | Hemorrhage
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| Thrombolytics | Used 3-6 hours post MI or 3 hours post ischemic stroke (NOT post hemorrhagic stroke) | break down clot to restore blood flow | Hemorrhage
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| Clotting Factor Replacement | Clotting deficiencies (hemophilia) | inhibit clot breakdown | Increased clotting
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| Statins | Hyperlipidemia | inhibit enzymes that make cholesterol | myalgia (rhabdomyalysis), nausea, liver toxicity, pancreatitis, arrhythmia, weakness, parasthesia
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| Fibric Acids | Hyperlipidemia | decrease triglycerides and increase VLDL | myalgia (rhabdomyalysis), nausea, liver toxicity, pancreatitis, arrhythmia, weakness, parasthesia
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| Antitussives (Codine) | Cough suppressants | suppress cough reflex and cause anesthesia | Sedation, GI upset, dependence, limit productive cough
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| Decongestants | Sinus congestion | Alpha-1 agonists (adrenergic agonists); vasoconstrict nasal mucosa | Palpitations, headache, nausea, dependence, nervousness
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| Mucolytics | Respiratory mucus; beneficial during P&PD | break-up muco-bonds | No major concerns
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| Expectorants | Respiratory congestion; beneficial during P&PD | increase ejection of phlegm | No major concerns
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| Anti-histamines | Allergies | block effects of histamine | Sedative, incoordination
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| Beta-adrenergic agonists | Bronchodilation (Asthma); beneficial during P&PD | stimulate beta-2 receptors and cause relaxation | Bronchial irritation, cardiac stimulation, CNS stimulation
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| Xanthine Derivatives | Bronchodilation (Asthma) | mechanism unclear | toxicity
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| Anti-cholinergic agents | Asthma and Parkinson disease | block acetylcholine to cause bronchodilation and reduce rigidity | Dry mouth, tachycardia, constipation, confusion
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| Cromones | Asthma and airway inflammation | block histamine | Unknown
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| Leukotriene modifiers | Asthma and airway inflammation | Leukotriene's are the prostaglandins of the airways | Unknown
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| Polysynaptic inhibitors | Muscle spasm | decrease excitation of polysynaptic neurons...decrease alpha motor neuron activity in spinal cord | Sedation
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| Diazepam (Valium) | Muscle spasm and spasticity | increase the inhibatory effects of GABA in brain and spinal cord | Sedation, generalized weakness, drastic changes in muscle tone
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| Baclofen | Spacticity | Synthetic GABA | Sedation, generalized weakness, drastic changes in muscle tone
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| Alpha-2 agonists | Spacticity | decrease excitation of alpha motor neuron | Sedation, generalized weakness, drastic changes in muscle tone
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| Gabapentin | Spacticity | Synthetic GABA | Sedation, generalized weakness, drastic changes in muscle tone
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| Botulinum toxin | Spacticity | muscle paralytic | Sedation, generalized weakness, drastic changes in muscle tone
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| Levodopa (L-dopa) | Parkinson disease | crosses blood brain barrier to replce dopamine | GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
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| Carbidopa | Parkinson disease; with L-dopa | inhibits L-dopa conversion into dopamine before crossing the blood brain barrier | GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
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| COMT inhibitors | Parikinson disease; with L-dopa | inhibits breakdown of L-dopa before crossing the blood brain barrier | GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
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| Dopamine agonists | Parkinson disease | synthetic dopamine | GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
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| Amantadine | Parkinson disease | decrease influence of Aceytlcholine | GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
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| Selegiline | Parkinson disease | inhibits MAO which breaks down dopine; therefore proloings the effect of dopamine | GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
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| Nitrates | Angina | cause vasodilation to decrease work of heart | dizziness, headache, reflex tachycardia
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| Digoxin (Digitalis) | Heart failure and arrhythmia | slows electrial conduction & increase force of contraction | arrhythmia, nausea, anorexia, mental status change, and hallucinations
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| Opioid (Narcotics) | Analgesic | alter pain perception at CNS (polysynaptic ot presynaptic) | Sedation, tolerance, dependence, confusion, postural hypotension, respiratory depression
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| NSAIDS | Analgesic, anti-inflammatory, antipyretic, anticoagulant | inhibit prostaglandin synthesis | gastric irritation, hepatic and renal toxicity
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