RESERPINE

GUANETHADINE

Blocks NE release

Prevents uptake of dopamine into vesicle and subsequent conversion to NE

COCAINE

AMPHETAMINES

Blocks reuptake of NE (tyrosine precursor) into presynaptic terminal

Cocaine used as topical anesthesia

affects alpha1, beta 1, DA1;

used in heart failure, DA receptors exist on heart and kidney afferent arterioles, therefore dopamine is able to increase contraction and CO

PHENYLEPHRINE

METHOXAMINE

NAPHAZOLINE

*PSEUDOEPHEDRINE

Alpha-1 Selective Agonists;

Used as Nasal decongestants, get the red out of eyes, decrease BP

pseudoephedrine: amphetamine precursor

alpha 1 + alpha 2 (periphery) agonist

used for nasal decongestion; vasoconstricts and restricts blood to nose, therefore less fluid to nose

CLONIDINE

GUANABENZ

GUANFACINE

alpha 2 (CNS) agonist; ANTI-HTN

administered low and slow; lowers BP by binding Alpha-2 receptors in CNS medulla, inhibiting SNS and lowering BP (never adds to preexisting tone d/t low conc., goes straight to brain);

sex problem in men, decrease exercise tolerance (d/t KOed SNS)

Non Selective Beta 1 + Beta 2 Agonist;

used as cardiac stimulant;

con: wide open vasodilation d/t absence of alpha activity

pro: increase HR w/o setting off reflex bradycardia b/c no change in MABP (B2 decreases TPR (DP) and B1 increases HR (SP)- MABP=)

Selective B1 Agonist;

used for cardiomyopathy and heart failure

ALBUTEROL

TERBUTALINE*

METAPROTERNOL

Selective B2 Agonist;

use as an inhalant for asthma + COPD (bronchodilator)

terbutaline: used in pregnant women

Selective B2 agonist;

uterine SM relaxation (keeps baby in) and vasodilates Blood Vessels (orthostatic hypOtension)

Non Selective Alpha 1+ Alpha 2 Antagonist;

NON-Competitive-> IRREVERSIBLE

used for pheochromocytomas (HIGH EPI);

reverses OD of Alpha Agonists

CON: b/c both Alphas KOed, nothing counters B2 vasodilation

Nonselective Alpha 1 + Alpha 2 Antagonist;

Competitive -> REVERSIBLE

used for Pheochromocytoma and reversal of Alpha Agonist OD

Dentists use to reverse local anesthetics

PRAZOSIN

TERAZOSIN

Selective Alpha 1 Antagonist

use to moderately drop BP in HTN patients;

leaves alpha 2 intact to counter B2 vasodilatio

Selective Alpha 2 (presynaptic CNS) Antagonist

non-clinical mood stimulant

**PROPANOLOL**

NADOLOL

TIMOLOL*

PINDOLOL

CARTELOL

Non Selective B1 and B2 Blocker

used for HTN

Timolol: used in Glaucoma and migraines

LABATALOL

CARVEDIOL

Non Selective B1 + B2+ A1 Antagonist

HTN emergencies and early stages of heart failure

***ATENOLOL***

METROPOLOL

ESMOLOL

ACEBUTOLOL

Selective B1 Antagonist;

used for Asthmatics (so B2 is still able to bronchodilate);

at high doses, drug becomes non-selective

accelerates NE vesicle release from presynaptic neuron;

enters neuron through Reuptake-1

found in CHEESE & WINE

don't mix with MAOIs (too much NE in cleft=severe HTN)

AMPHETAMINE

PSEUDO-EPHEDRIN

accelerates release of NE from presynaptic neuron

indicated for ADD, narcolepsy

Amphetamines + Cocaine is BAD

Ephedrine increases chance of MI

low dose: block NE uptake

high dose: block Na channel

*cocaine does this too

PARGYLINE

TRANCYPROMINE

MAO inhibitors (prevent NE metabolism)

used for depression

contraindicated with tyramine

**NITROGLYCERIN**

Isosorbide

Dinitrate

Amyl Nitrate

Organic Nitrate Anti-Anginal;

Nitric Oxide reacts with tissue sufhydryl

Vasodilates ARTERIOLES & VEINS

side effect: orthostatic hypOtension

Dihydropyridine Calcium Channel Blocker

Inhibits Ca++ entry into L-type VC in vessels

mainly dilates vessel (no heart effects)

Used for HTN and Angina

Side effect: orthostatic hypOtension

VERAPAMIL

DILTIAZEM

Non-Dyhydropyridine Calcium Channel Blocker

heart effects and vessel vasodilation

increase activity at AV node

may contribute to AV block

contraindicated w/B blockers d/t -ve ionotropic effects on heart (arrythmia)

irreversible inhibitor of COX (TXA2 synthesis); ANTI-PLATELET

prophylaxis for clots

w/OD, forced alkaline diuresis with Acetazolamide

Adverse effects: bleeding, decreased PLT, hypersensitivity, Reye's

Inhibits Thromboxane Synthase and Phosphodiesterase (cAMP decrease)

prophylaxis for prosthetic heart valves

adverse: GI effects, rash, dizziness

TICLOPIDINE

CLOPIDOGREL

irreversible inhibitor of ADP receptor (on PLT surface)

used in ASA intolerant pts

prevents silent thrombosis

Increased incidence of TTP

Non-competitive inhibitor of GFP IIb/IIIa

uses Fab fragment of Ab against GFPIIb receptor

used w/ASA + Heparin for thromboses + prevention of MI

Decreased restenosis and recurrent MIs

Competitive Antagonist of GFP IIb/IIIa receptor

competes with Fibrinogen

used for Acute Coronary Syndrome and prevents stent thrombosis

less risk than Abciximab for hemorrhage

increase ATIII activity; blocks thrombin

anticoagulant

used for DVT, embolism, unstable angina, MI

LMW half life > HMW half life

in case of Heparin Induced Thrombocytopenia w/HMW Hep, use protamine sulfate (antagonist)

irreversible thrombin inhibitor

ANTICOAGULANT

used for Heparin Induced Thrombocytopenia

Reversible Thrombin inhibitor

ANTICOAGULANT

used for Heparin Induced Thrombocytopenia

Occupies catalytic site of thrombin

used for Percutaneous Coronary Angioplasty

Binds exosite 1 on thrombin to prevent fibrinogen cleavage;

Stroke prevention in A-FIB patients;

less patient monitoring needed than warfarin

Blocks VKOR in F II, VII, IX, X *all the ones that use Vit K*

used for DVT, PE, systemic thrombus

stops forming new coag factors (not existing ones)

Used with Heparin initially (b/c it's slower than hep)

ANTIDOTE: Phytonadione (Vit K)

Complexes with Plasminogen and promotes it's action

Used to treat MI

systemic reactions, allergy possible

First Gen. Direct activators of Plasminogen

Treat MI

prefers binding plasminogen bound to fibrin (less systemic rxns than streptokinase)

2nd gen. Direct activator of Plasminogen

Used to treat MI

Less fibrin specific than tPA, but greater 1/2-life

2nd gen. Direct Activator of Plasminogen;

Treat MI

More Fibrin specific than tPA

resistant to plasminogen inhibitors

MANNITOL

Urea

GLYCERIN

Isosorbide

increases urine osmolality

used for elevated ICP and Glaucoma

*Mannitol, urea-IV

*Glycerin, Isosorbide- oral

GLYCERIN

ISOSORBIDE

Carbonic Anhydrase Inhibitor at PCT

FOrced alkaline diuresis *ASA OD*

Altitude sickness  (acidic blood has less affinity for Oxygen in tissues)

Metabolic alkalosis (acidifies blood)

Open angle glaucoma

FUROSEMIDE

Ethacrynic acid

Bumetadine

Torsemide

Loop Diuretic (TAL) that inhibits NKCC

used for HTN, edema, SIADH

increases prostaglandin --> decreases BP

CHLORATHIAZIDE

CHLOROTHALIDONE

METOLAZONE

Thiazide; inhibit NCC (Sodium Chloride Cotransporter) at DCT

arterial vasodilator (decreased afterload)

DOC for HTN, Nephrogenic Diabetes Insipidus, hypocalcemia (no Na gradient, so no reabsorption of Ca)

AMILORIDE

TRIAMTERENE

K+ Sparing Diuretic; ENaC Blocker on late DT and CD

No Endocrine Effects

K+ Sparing Diuretics; Aldosterone receptor Antagonist on late DT and CD;

Endocrine effect-gynecomastia

CONIVAPTAN

TOLVAPTAN

Demecocycline

Lithium**

AQUARETICs; vasopressin antagonist at late DT & CD

used for SIADH and hyponatremia

Lithium linked to nephrogenic diabetes insipidus (use NSAIDs to treat)

AMINOCAPROIC ACID

TRANEXAMIC ACID

inhibiton of plasminogen activation

ANTIDOTE for OD on Thrombolytics